Will the Strategies of Stroke Prevention Change with the New Diagnostic Standard of Hypertension?

Hypertension is the most important risk factor for stroke, which is not well controlled in China. The rates of awareness, treatment, and control of hypertension are low. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults redefines hypertension, setting the threshold of hypertension at 130/80 mm Hg(1 mm Hg=0.133 kPa). By this standard, new therapeutic targets and management strategies for hypertension were formulated. The guideline is based on the results of Systolic Blood Pressure Intervention Trial (SPRINT), which indicate that intensive antihypertensive therapy reduces the incidence of cardiovascular events and all-cause mortality compared with the standard blood pressure control. But at the same time, this standard increases the number of patients with hypertension and affects the treatment measures in most people including the elderly and the weakened population. It increases the economic burden while increasing the adverse reactions in special populations, which is not conductive to the prevention and individualized treatment of hypertension. Therefore, by this hypertension standard, according to the existing medical evidence, it is suggested that strategies of stroke prevention, especially primary prevention, should be changed in China.