Single Blood Pressure Reading Predicts Risks
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May 25, 2004 -- A single change in just one vital sign measure
among people with hypertension may be an early warning sign of future heart
risk. New research shows that individual changes in vital sign measure --
especially blood pressure -- are an important predictor of heart disease, heart
attack, and stroke.
Researchers say doctors are often reluctant to make changes in
a patient's high blood pressure treatment based on the results of a single
blood pressure reading because blood pressure can vary substantially throughout
But this study showed that relatively small changes in blood
pressure readings recorded at a single office visit were significant predictors
of future heart disease risks. For example, a 10 mmHg increase in average blood
pressure predicted a 12% increased risk of heart failure.
Researchers say those results show that changes in vital signs
measures taken at a single visit should not be ignored by doctors.
"Too often in practice a physician may be tempted to ignore
a single elevated blood pressure reading, as in, for example, noncompliant
patients or those in pain or under stress, opting to wait and reassess the
patient during the next visit," write researcher William M. Tierney, MD, of
Wishard Memorial Hospital in Indianapolis, and colleagues. "Yet,
hypertension is a well-recognized cardiovascular risk factor, and elevations
should generally be treated unless there are compelling reasons not to
Blood Pressure Check Predicts Risk
In the study, published in the May/June issue of the Annals
of Family Medicine, researchers obtained information on vital sign measures
recorded on the first primary care visit of 5,825 people with hypertension.
Vital signs measures generally obtained at office visits include blood
pressure, pulse, weight, and temperature.
During a 5.5-year follow-up period the study showed 7% of the
patients had a heart attack, 17% had a stroke, 24% developed significant
atherosclerotic heart disease, 22% had heart failure, and 12% developed
decreased kidney function.
After taking into account other factors that might affect a
person's risk of heart disease, researchers found that changes in the vital
sign measures from the patient's initial visit, especially blood pressure, were
closely associated with heart disease health-related risks.
Specifically, the study showed an increase in the systolic (the
top number in a blood pressure reading) was the most consistent vital sign
measure in predicting health problems. The study showed a 10 mmHg increase in
systolic blood pressure was associated with:
- 13% increased risk of decreased kidney function
- 9% higher risk of atherosclerotic heart disease
- 7% increased risk of stroke
- 6% higher risk of first stroke or heart attack
In addition, an increase in heart rate (or pulse) of 10 beats
per minute predicted a 16% increased risk of death.
Researchers say that blood pressure and heart rate are truly
vital signs and a single reading in people with high blood pressure should be
taken seriously and managed with appropriate medical therapies.