Wrong blood-pressure readings being followed to prevent stroke and heart attack, leader of biggest study says

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Providers hoping to get a grip on the likelihood of patients suffering a stroke or an adverse cardiovascular event should pay more attention to nighttime hypertension readings, researchers say.

An examination of nearly 14,000 individuals' records showed that the risk of heart attack or stroke jumped 25% for every 10-point increase in systolic blood pressure at night.

Researchers studied the records of nine groups of people in Japan, Europe and Brazil for at least a year in the largest study of its kind. Each time slot that was monitored saw a rise in risk of myocardial infarction or stroke as blood pressure rose. For every 10-mm-Hg increase in blood pressure, risk rose 25% for nighttime, 20% for daytime and 11% for clinic readings, researchers said.

But when adjusting for variables such as age, gender, smoking status, diabetes and other factors, only the night measurement readings were predictive of the adverse events, lead investigator George Roush, M.D., of St. Vincent's Medical Center in Bridgeport, CT, told news outlet heartwire.

"When you put all three measurements in the same model, nighttime persists at the same level of prediction, but day and clinic are totally useless," Roush said. "Every practical clinical decision we make is based on clinic blood pressure, yet it's the least predictive of all three."

Study results were discussed in the April issue of the Journal of the American Society of Hypertension.

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