Episode 366: 377. Does How Long You Have Hypertension Matter?

Association of Duration of Recognized Hypertension and Stroke Risk: The REGARDS Study

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Hypertension is a well-known risk factor for stroke, but this study, led by Dr. George Howard and colleagues, asks a fascinating question: Does the duration of hypertension matter, even when blood pressure is managed?

(Transition Music - Short and subtle - 2 seconds)Host: The researchers used data from the REGARDS study, a large, long-term study looking at racial and geographic differences in stroke. They followed over 27,000 stroke-free participants for over 12 years, tracking who developed stroke and how long they had been diagnosed with hypertension. Participants were grouped by duration of hypertension: normotensive (no hypertension), 5 years or less, 6 to 20 years, and 21 years or more.

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So, what did they find? Several key findings emerged. First, people with longer durations of hypertension were taking more antihypertensive medications, suggesting it becomes harder to manage blood pressure over time. Second, even with medication, their average systolic blood pressure (the top number) was higher.

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Host: Most importantly, the study found a clear association between the duration of hypertension and stroke risk. Compared to people with normal blood pressure, those with hypertension for 5 years or less had a 31% increased risk of stroke. That risk jumped to 50% for those with hypertension for 6 to 20 years, and a staggering 67% for those with hypertension for 21 years or more. These increased risks remained even after the researchers accounted for factors like age, race, sex, and other stroke risk factors.(Transition Music - Short and subtle - 2 seconds)

Host: Key Takeaway: This study strongly suggests that the duration of hypertension significantly impacts stroke risk, independent of blood pressure levels at a single point in time.(Transition Music - Short and subtle - 2 seconds)

Host: What does this mean for you? It reinforces the importance of preventing or delaying the onset of hypertension in the first place. Early lifestyle interventions, such as diet and exercise, can play a crucial role. If you're already diagnosed with hypertension, work closely with your doctor to manage your blood pressure effectively and consider how long you've had the condition as part of your overall risk assessment. The longer you have hypertension, the more vigilant you may need to be.