Do Hypertensive Men Know Their Risk for Stroke?

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Men who are at the highest risk for stroke have little knowledge about the role that high blood pressure plays in this risk. This is the conclusion of a study published in the Journal of Clinical Hypertension in April of 2008.

The study was conducted at Duke University in Durham, NC, and was partially supported by the Agency for Healthcare Research and Quality (AHRQ), a division of the U.S. Dept. of Health and Human Services. Participants consisted of 296 men with high blood pressure (hypertension/HTN). All of them were veterans enrolled in the Veterans Study to Improve the Control of Hypertension (V-STITCH). Each participant was asked to estimate his risk of stroke based on his HTN. Results of the study indicate that "patients tend to underestimate their own risk."

Stroke is the third most common cause of death in the U.S. It is the most common cause of disability. HTN is the most frequent primary diagnosis in the U.S. Inadequate control of blood pressure can be linked to 62 percent of cerebrovascular disease (disease related to the blood vessels in the brain).

In this study, "actual stroke risk" was based on the Framingham Stroke Risk (FSR) scale. FSR calculates risk not only using the diagnosis of HTN but also includes diabetes, cardiovascular disease, smoking status, presence of atrial fibrillation, and evidence of left ventricular hypertrophy. "Perceived stroke risk" was based on the patient's knowledge of HTN, his belief that HTN is serious, his degree of concern regarding his HTN, and whether or not he was taking his blood pressure medicine and making lifestyle changes. Age, race, education level, income level, and amount of regular exercise were also noted.

The results showed that 77.9 percent of these men underestimated their risk for having a stroke when their "perceived risk" was compared to their "actual risk."  Only 12.4 percent of these patients perceived their risk to be as high as their FSR score indicated. The authors of the study concluded that educating patients about their true stroke risk would help them to become more compliant with treatment.

For further information, refer to "Perceived and Actual Stroke Risk Among Men With Hypertension," Powers, B MD; Oddone, E MD MHS; Grubber J MSPH; Olsen, M PhD; Bosworth, H PhD; The Journal of Clinical Hypertension, Volume 10, Number 4, April 2008.