Long term changes in blood pressure and risk of cerebrovascular disease.

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Abstract
The incidence of cerebrovascular disease [CBVD] and the relation of blood pressure [BP] to CBVD were previously studied in 3983 North American men (predominantly between 25-34 yr of age who were measured 5 times during the 26 yr observation period. Used were measurements of age, systolic (SBP) and diastolic (DBP) blood pressure and Body Mass Index-weight/height. Change was calculated as the difference in these variables between examinations. In order to adjust for age and BP as CBVD risk factors, as well as for the effect both may have on the rate of BP change, the data were analyzed using multivariate as well as univariate methods. After adjusting for age and SBP, change in SBP was significantly associated with subsequent CBVD, primarily in men middle aged or older. When considering SBP after entry, changes from a measurement 5 yr earlier were more important than SBP changes over longer intervals. In evaluating SBP as a risk factor for CBVD, the rate of change in SBP is also an important factor in the identification of the stroke prone individual.