期刊
NEUROLOGY
卷 82, 期 13, 页码 1153-1161出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0000000000000268
关键词
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资金
- Health Ministry of Guangdong province [B2011310, A2012663, B2012343]
- Scientific Research Fund of Foshan, Guangdong, China [201208210, 201208227]
- Cardiovascular Medicine Research Fund of Guangdong, China [2009X20, 2011X38]
- Natural Science Foundation of Guangdong Province [8151051501000048]
- Guangdong Provincial Science and Technology projects [2009B030801204, 2012B031800184]
- Guangzhou City Science and Technology projects [2010YC181]
- National Natural Science Foundation of China [81270320]
Objective:In this meta-analysis, we sought to evaluate the association between prehypertension and the risk of stroke.Methods:We searched PubMed and EMBASE databases for studies with data on prehypertension and stroke. Two independent reviewers assessed the reports and extracted data. Prospective studies were included if they reported multivariate-adjusted relative risks (RRs) with 95% confidence intervals (CIs) for the associations between stroke and prehypertension or its 2 subranges (low-range prehypertension: 120-129/80-84 mm Hg; high-range prehypertension: 130-139/85-89 mm Hg). We conducted subgroup analyses according to blood pressure ranges, stroke type, endpoint, age, sex, ethnicity, and study characteristics.Results:Pooled data included the results of 762,393 participants from 19 prospective cohort studies. Prehypertension increased the risk of stroke (RR 1.66; 95% CI 1.51-1.81) compared with optimal blood pressure (<120/80 mm Hg). In the secondary outcome analyses, even low-range prehypertension increased the risk of stroke (RR 1.44; 95% CI 1.27-1.63), and the risk was greater for high-range prehypertension (RR 1.95; 95% CI 1.73-2.21). The RR was higher with high-range than with low-range prehypertension (p < 0.001). There were no significant differences in any of the subgroup analyses (all p > 0.05).Conclusions:After adjusting for multiple cardiovascular risk factors, prehypertension is associated with stroke morbidity. Although the increased risk is largely driven by high-range prehypertension, the risk is also increased in people with low-range prehypertension.
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