Following new blood pressure guidelines could prevent deaths among stroke survivors

Using the latest guidelines on high blood pressure would result in nearly 950,000 more U.S. stroke survivors diagnosed with the disease and could reduce deaths among stroke survivors by nearly one-third, 根据一项新的研究.

这项研究, published Wednesday in the Journal of the 美国心脏协会, 在检测指南更新之后, 管理, 预防和治疗高血压, 或者高血压, a condition in which the force of blood flowing through the blood vessels is too high. 去年11月, the American College of Cardiology and 美国心脏协会 issued new guidelines in more than a decade, 将高血压重新定义为130/80而不是之前的140/90.

Researchers wanted to see how the new guidelines might impact survivors of stroke, 脑部供血中断，可导致瘫痪, 言语不清，大脑功能改变. 未被发现或控制的高血压可导致中风, 以及心脏病发作和心力衰竭.

“有可能减少中风幸存者的死亡人数,该研究的主要作者说, Dr. 阿兰Lekoubou, a clinical neurophysiology fellow and clinical instructor at the Medical University of South Carolina in Charleston.

“在中风管理方面已经取得了重大进展. However, 许多人仍然死于中风,他说, 数据显示，在估计的800人中,在美国，每年仍有5000人中风.S.在美国，近四分之一的人是复发性中风.

这项研究 looked at data from more than 6 million people age 20 and older who took part in federal surveys between 2003 and 2014. Investigators used the data to compare the new ACC/AHA hypertension guidelines with older high blood pressure guidelines known as Joint National Guidelines Seventh Report, or JNC7.

研究人员发现，与JNC7相比, the new ACC/AHA hypertension guidelines resulted in a 67 percent relative increase in U.S. 应该接受高血压治疗的中风幸存者, from 1,415,974人生还，2人生还,361,075. Death rates among stroke survivors would go down by nearly a third, from 8.3%到5%.研究显示，如果采用新的指导方针，则为6%.

根据新的指导方针, more stroke survivors will now have hypertension … and the proportion of stroke survivors that will be recommended blood pressure medications will be much higher,勒库布说. “Our results highlight the potential challenges in implementing into practice the new guidelines, 但也增加了中风死亡率持续下降的希望.”

Lekoubou said he’d like to see more in-depth studies that examine how many doctors are adhering to the new guidelines, 社交媒体如何帮助更多的人使用这些指南, and how the guidelines are impacting stroke recurrence and mortality.

Dr. 布莱恩银, 伍斯特马萨诸塞州纪念医疗中心的神经学家, 麻萨诸塞州, called the study “a very impressive analysis that raises the awareness of the importance of getting blood pressure down further.”

Silver, 谁没有参与这项研究, said some doctors have been reluctant to treat stroke victims – especially older patients – who don’t meet the new blood pressure threshold.

“Some [doctors] say it’s very difficult to get people down to 130 or 120, that it requires a lot of medication and there’s a concern we could make people hypotensive, which is when the blood pressure is too low that it might reduce oxygen to the brain, 会导致痴呆,他说. “Physicians also worry about polypharmacy – patients taking too many medications.”

The key, Silver said, is treating patients on a stringent case-by-case basis. 他把这个过程称为“部分科学，部分艺术”.”

“We have the scientific data, but we also have to ask how old is the patient? 他们是(接受药物治疗的)最佳人选吗?? There’s a fine balance in terms of trying to hit a target, but not overshooting the target,他说.

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