Objectives To analyse the type of blood pressure, blood pressure classification and pulse pressure among patients with uncontrolled hypertension and their relations with ischemic stroke
Methods A total of 3909 uncontrolled hypertensive patients aged 35 years and above were identified from screening in the patients pool of community health stations/centres and tertiary Anzhen Hospital from March to December 2012, of whom 144 had ischemic stroke.
Results There were 1932 (49.4%) males and 1977 (50.6%) females. Most (61.3%) patients had the lowest degree of blood pressure classification. The percentages of patients with uncontrolled diastolic pressure only, uncontrolled systolic pressure only and both uncontrolled were 18.5%, 33.8% and 47.7%, respectively. More female patients have both systolic and diastolic pressures uncontrolled (40.27% compared to 27.4%), while fewer females having only systolic pressure uncontrolled (13.9% compared to 23.9%). The likelihood for patients below 55 in developing uncontrolled systolic pressure was low (6.5% in age group of 35-44, 17.9% in age group of 45-54). The likelihood of patients above 65 in developing uncontrolled diastolic pressure was even lower (6.7%). After multivariable adjustment for age, gender, smoke, drink, BMI, dyslipidemia and exercise, the likelihood of developing ischemic stroke is 50% lower in patients with only uncontrolled diastolic pressure than patients with both diastolic and systolic pressure uncontrolled. The OR is 0.493 (95% CI:0.256∼0.947). The risk of stroke in individuals with diabetes was one point five times higher than individuals without diabetes OR = 2.534 (95% CI:1.726∼3.720). There was no significant association between blood pressure classification and risk of stroke and between pause pressures and risk of stoke.
Conclusions Systolic pressure was not controlled in most patients with uncontrolled blood pressure. The risk of stroke increased significantly in patients with uncontrolled systolic pressure, of higher age and with diabetes.