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Can Strokes be Predicted by Blood Pressure Patterns?

It's been a big month for cardiovascular health recognition. And while National High Blood Pressure Awareness Month and American Stroke Month are coming to an end, Battelle Healthcare Colloquium urges you to keep a recent blood pressure and stroke study in mind at your next family physician or cardiologist appointment.

The Rotterdam Study, whose report was originally published on May 9, 2016 in the journal Hypertension, was conducted by Dr. Marileen Portegies, with the department of epidemiology at Erasmus University Medical Center in Rotterdam, the Netherlands, and a team beginning in 1990. Portegies' team collected systolic blood pressure readings of more than 6,700 Dutch adults, between the ages of 55 to 106, for 20 years.

Four blood pressure patterns were identified in the study:

  • Class I was characterized by a gradual increase in blood pressure from normal systolic blood pressure to high blood pressure (120 to 160 mm Hg) over five decades.
  • Class II was characterized by normal systolic blood pressure in middle age, but a steep rise to very high blood pressure (120 mm Hg to 200 mm Hg).
  • Class III was characterized by moderately high blood pressure (140 mm Hg) in middle age that did not change much.
  • Class IV was characterized by high blood pressure (160 mm Hg) in middle age, which decreased after 65. This pattern was more frequent in men. These patients were more likely to take blood pressure medication.

Compared to people whose blood pressure increased gradually, people whose high blood pressure dropped after the age of 65 had the highest risk of stroke. 13.6% of these individuals suffered from a stroke. Those whose blood pressure rose steeply had an 8% greater risk of stroke, and adults whose moderately high blood pressure stayed stable had an almost 5% greater risk of stroke.

High blood pressure is the No. 1 risk factor for stroke. However, associations of blood pressure with stroke risk are mostly based on single or average blood pressure readings. Within this population-based study, researchers concluded that doctors may need to review patients' overall blood pressure patterns in order to predict stroke risk or early death.

At Battelle, we're proud of Battelle Healthcare Colloquium's member hospitals for striving to make the world a better place by improving heart failure patient outcomes every day through research, experience, and expertise. Our hospital membership organization comprises 30 distinguished adult and pediatric hospitals, 11 of which have top pediatric cardiology programs as ranked by U.S. News & World Report. Battelle Healthcare Colloquium transforms healthcare organizations by improving patient outcomes through Heart Failure Accreditation. If your healthcare organization is interested in Heart Failure Accreditation, contact the Battelle Healthcare Colloquium team. Visit for more information.