Blood pressure parameters and risk of fatal stroke, NHANES II mortality study

Background: Recent studies have suggested that systolic blood pressure (BP) is a better predictor of stroke than diastolic BP in apparently healthy white men. Whether these relationships are similar for women and African Americans remains unclear. Methods: We used data from 6667 (3205 men; 3462 women) adults from the Second National Health and Nutrition Examination Survey Mortality Study to examine whether the relative risk of fatal stroke was associated with a 10 mm Hg increase in BP parameters (systolic BP, diastolic BP, pulse pressure, and mean arterial pressure). Results: During a median of nearly 15 years of followup, 113 fatal strokes (62 men; 51 women) occurred. Systolic BP was associated with an increased risk of fatal stroke for men (relative risk [RR] = 1.19), women (RR = 1.15), whites (RR = 1.17), and African Americans (RR = 1.28) after multivariable adjustment (all, P <= .05). Results for other BP parameters were not consistent; simultaneous consideration of two parameters did not improve prediction of fatal stroke over systolic BP alone. Conclusions: Our results agree with previous studies that indicate systolic BP is an important predictor of stroke risk for all groups within the population and provide further evidence of the need to control systolic BP in the population.