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Medicine Eds. Souhami and Moxham. Pub. Churchill Livingstone 2002
Strokes can be caused either by a blood clot [link widoczny dla zalogowanych], the most common cause, often through atherosclerosis as just mentioned or by rupture of a blood vessel in the brain and high blood pressure is thought to be a risk factor for this.
Prognostic significance of visit to visit variability, maximum systolic blood pressure, and episodic hypertension. Rothwell et al The Lancet 375, 9718, 13 March 2010.
High Blood Pressure and Stroke
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As mentioned earlier, exactly how high blood pressure causes problems in the cardiovascular system and therefore damage to the brain [link widoczny dla zalogowanych], heart and kidneys, is unknown. This interesting study points the way to further research which may shed some light on this area.
The evidence for high blood pressure being a major risk factor in the development of cardiovascular disease - that is heart disease and strokes - arose from the Framingham Study in 1970.
Although high blood pressure is known to adversely affect the cardiovascular system the precise mechanism of action is not clear. It is known that high blood pressure accelerates the production atherosclerosis in the arteries and therefore increases the risk of developing blood clots which in turn will impede blood flow causing heart attack or stroke.
Episodic High Blood Pressure
There's been a hiccough in the field of blood pressure medicine. Recent research findings may cause doctors to rethink their approach to managing the risks of high blood pressure.
Implications of The Research
Research in a paper published in The Lancet on 13th March has found that patients with variable blood pressure (that is [link widoczny dla zalogowanych], fluctuating between normal and high) are at greater risk of stroke than those with consistently high blood pressure (hypertension).
Clearly the results of this study have implications for management of high blood pressure in that in future treatment might be aimed at stabilising blood pressure as well as maintaining it at a lower level.
Up until now, the diagnosis of hypertension has been made on a series of measurements, often three taken at intervals to establish the average blood pressure reading. A high reading followed by a couple of low ones might average out as normal and therefore it might be likely that no treatment regime for hypertension would be initiated.
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In the Lancet study, the researchers determined the visit to visit variability in blood pressure of patients and compared this to risk of stroke. They found a stronger relationship to stroke in patients with variable blood pressure than those with consistently high blood pressure. They also found that those subjects whose blood pressure rose the highest were at greatest risk from stroke.
This article is for information only, if you have any health concerns you should consult your doctor.
This ongoing research program involving a proportion of the population of Framingham Massachusetts has yielded an enormous amount of information on the effects of lifestyle on disease development.

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