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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 the day.

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 treat."

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.

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