Early BP Screening in Offspring of Stroke Patients Warranted


TUCSON, ARIZ. — Patients with a parental history of stroke should be screened early for raised blood pressure, Dr. Nigel Hart said at the annual meeting of the North American Primary Care Research Group.

The recommendation was drawn from Dr. Hart's Stroke Offspring Study in which systolic and diastolic blood pressures were significantly higher in patients with a parental history of stroke, compared with matched controls. Stroke offspring also consumed more alcohol than their paired controls but did not differ significantly with respect to body mass index, lipids, diabetes mellitus, diet, smoking status, or exercise.

“Given the very-well-established relationship between blood pressure and stroke risk, these results suggest that higher blood pressure in stroke offspring may contribute to their increased risk of stroke,” said Dr. Hart of Queen's University, in Belfast, Ireland.

“This group may particularly benefit from a blood pressure screening strategy,” he added.

Questionnaires were sent to randomly selected individuals, aged 40–64 years, from 11 general practices representing 6% of the population of Northern Ireland. From the returns, those with a parental history of stroke (cases) were matched on age, gender, and socioeconomic status to those with no parental history of stroke (controls).

Matched pairs answered questions about smoking, alcohol, and medical history, and underwent a clinical evaluation. A total of 458 individuals were screened, and complete data were available on 398 individuals or 199 case-control pairs.

Systolic and diastolic blood pressures were significantly higher in cases than in controls; (systolic 146.2 mm Hg vs. 140.6 mm Hg) and (diastolic 87.7 mm Hg vs. 85.0 mm Hg).

There were no significant differences between groups in total cholesterol, homosysteine levels, smoking status, or presence of diabetes, Dr. Hart and colleagues reported.

The only variable that was statistically different between groups was alcohol consumption, with cases drinking 3.7 more alcohol units per week than controls (13.8 U vs. 10.1 U). A pint of beer is equal to 2 units, while a glass of wine or hard liquor is equal to 1 unit.

The number of stroke offspring that drank above United Kingdom recommended limits was significantly higher than for controls (57 vs. 40). The recommended allowance for females is 14 U/week and 21 U/week for males.

The mean paired difference in diastolic (2.4 mm Hg) and systolic (5.5 mm Hg) blood pressures was statistically significant between groups even after adjusting for alcohol consumption using a stepwise logistic analysis, he said.


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