Short-term blood pressure changes have a more strong impact on stroke and its subtypes than long-term blood pressure changes

Abstract

Background: Elevated blood pressure (BP) is closely related to stroke and its subtypes. However, different time periods changes in BP may result in differential risk of stroke. Hypothesis: Short-term blood pressure changes have a more strong impact on stroke and its subtypes than long-term blood pressure changes. Methods: We designed the study on the effects of short- (2008-2010) and long-term (2004-2010) BP changes on stroke events (2011-2017), including 22 842 and 28 456 subjects, respectively. The difference in β coefficients between short- and long-term BP changes on the effects of stroke were examined using the Fisher Z test. Results: During a median 12.5-year follow-up period, 1014 and 1505 strokes occurred in short- and long-term groups. In short-term group, going from prehypertension to hypertension, the risk of stroke events increased (stroke: hazard ratio [HR] = 1.537 [1.248-1.894], ischemic stroke: 1.456 [1.134-1.870] and hemorrhagic stroke: 1.630 [1.099-2.415]); going from hypertension to prehypertension, the risk of stroke events decreased (stroke:0.757 [0.619-0.927] and hemorrhagic stroke:0.569 [0.388-0.835]). Similarly, in long-term group, going from prehypertension to hypertension, individuals had an increased risk of stroke (1.291, 1.062-1.569) and hemorrhagic stroke (1.818, 1.261-2.623); going from hypertension to prehypertension, participants had a decreased risk of stroke (0.825, 0.707-0.963) and hemorrhagic stroke (0.777, 0.575-0.949). Furthermore, the effects of BP changes during short-term period on stroke events were greater than that in long-term period. Conclusions: Short- and long-terms BP changes were both associated with the risk of stroke events. Furthermore, short-term BP changes had a stronger impact than did long-term changes on risk of stroke events.