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Western blood pressure targets ‘boost stroke risk in Asians’

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Latest European and North American blood pressure guidelines may actually boost the stroke risk if used for Asian patients, particularly the elderly, according to experts.

High blood pressure is a key risk factor for stroke, but the link between the two is much stronger in Asians than it is in Europeans or North Americans, argue Italian academics in the journal Heart Asia.

They said hypertension among Asian populations had “unique” features in terms of the response to drug treatment, risk of complications, and outcomes.

It leads to disproportionately high rates of death and ill health from stroke, compared with Western populations, they noted, adding that the impact of Western-style diets being increasingly adopted by Asian people had also contributed to the problem.

The latest Western guidelines, such as published in 2013 by the European Society of Hypertension, increased target blood pressure to 140/90mmHg for patients at high risk of cardiovascular disease and renal failure.

However, this may be too high for Asian populations, warned the authors. A threshold below 140/90 mmHg might be more appropriate, they suggested.

“The paucity of data on the correct definition of the most appropriate [blood pressure] target in elderly patients, highlighted by the few available trials, should be perceived as a stimulus for future research in Asia, not as an argument for questioning the benefit of treatment,” they added.

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