{"doi":"10.1161/01.hyp.34.6.1181","title":"J-Shaped Relation Between Blood Pressure and Stroke in Treated Hypertensives","abstract":"<jats:p>\n            <jats:italic>Abstract</jats:italic>\n            —The objective of this study was to investigate the relationship between hypertension and risk of stroke in the elderly. The study was performed within the framework of the Rotterdam Study, a prospective population-based cohort study. The risk of first-ever stroke was associated with hypertension (relative risk, 1.6; 95% CI, 1.2 to 2.0) and with isolated systolic hypertension (relative risk, 1.7; 95% CI, 1.1 to 2.6). We found a continuous increase in stroke incidence with increasing blood pressure in nontreated subjects. In treated subjects, we found a J-shaped relation between blood pressure and the risk of stroke. In the lowest category of diastolic blood pressure, the increase of stroke risk was statistically significant compared with the reference category. Hypertension and isolated systolic hypertension are strong risk factors for stroke in the elderly. The increased stroke risk in the lowest stratum of blood pressure in treated hypertensive patients may indicate that the therapeutic goal of “the lower the better” is not the optimal strategy in the elderly.\n          </jats:p>","journal":"Hypertension","year":1999,"id":652520,"datarank":0.7806010030615194,"base_score":5.204006687076795,"endowment":5.204006687076795,"self_citation_contribution":0.7806010030615194,"citation_network_contribution":0.0,"self_endowment_contribution":0.7806010030615194,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":181,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":489064,"name":"Michiel L. Bots","orcid":"0000-0003-2871-9810","position":1,"is_corresponding":false},{"id":361118,"name":"Albert Hofman","orcid":"0009-0007-3564-3267","position":2,"is_corresponding":false},{"id":85659,"name":"Peter J. Koudstaal","orcid":"0000-0003-4998-9609","position":3,"is_corresponding":false},{"id":1702183,"name":"Jacqueline C. M. Witteman","orcid":null,"position":4,"is_corresponding":false},{"id":74515,"name":"Monique M. B. Breteler","orcid":"0000-0002-0626-9305","position":5,"is_corresponding":false},{"id":1702182,"name":"Zoltán Vokó","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"J-Shaped Relation Between Blood Pressure and Stroke in Treated Hypertensives","abstract":"<jats:p>\n            <jats:italic>Abstract</jats:italic>\n            —The objective of this study was to investigate the relationship between hypertension and risk of stroke in the elderly. The study was performed within the framework of the Rotterdam Study, a prospective population-based cohort study. The risk of first-ever stroke was associated with hypertension (relative risk, 1.6; 95% CI, 1.2 to 2.0) and with isolated systolic hypertension (relative risk, 1.7; 95% CI, 1.1 to 2.6). We found a continuous increase in stroke incidence with increasing blood pressure in nontreated subjects. In treated subjects, we found a J-shaped relation between blood pressure and the risk of stroke. In the lowest category of diastolic blood pressure, the increase of stroke risk was statistically significant compared with the reference category. Hypertension and isolated systolic hypertension are strong risk factors for stroke in the elderly. The increased stroke risk in the lowest stratum of blood pressure in treated hypertensive patients may indicate that the therapeutic goal of “the lower the better” is not the optimal strategy in the elderly.\n          </jats:p>","is_dataset_classified":null,"base_score":5.204006687076795,"endowment":5.204006687076795,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"10601115","pmcid":null,"openalex_id":"https://openalex.org/W2140792127","authors":[],"funders":[],"total_grants":0,"fwci":7.5686,"citation_percentile":0.98007134,"influential_citations":0,"citation_trend":[{"year":2012,"count":12},{"year":2013,"count":8},{"year":2014,"count":17},{"year":2015,"count":6},{"year":2017,"count":7},{"year":2018,"count":1},{"year":2019,"count":6},{"year":2020,"count":4},{"year":2021,"count":1},{"year":2022,"count":4},{"year":2023,"count":2},{"year":2024,"count":4},{"year":2025,"count":2}],"oa_status":"green","license":"other-oa","oa_locations":[{"url":"https://pure.eur.nl/files/46593219/10601115.pdf","host_type":"repository"},{"url":"https://pure.eur.nl/files/46593219/10601115.pdf","host_type":"repository"},{"url":"https://www.ahajournals.org/doi/full/10.1161/01.HYP.34.6.1181","host_type":"publisher"},{"url":"https://pure.eur.nl/en/publications/ae5aef77-9caf-47bd-aaa2-b0649533083a","host_type":"repository"},{"url":"https://doi.org/10.1161/01.hyp.34.6.1181","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/10601115","host_type":"repository"},{"url":"http://hdl.handle.net/1765/9215","host_type":"repository"},{"url":"http://repub.eur.nl/pub/9215","host_type":"repository"}],"fields_of_study":["Blood Pressure and Hypertension Studies","Cardiovascular Health and Disease Prevention","Sodium Intake and Health"],"mesh_terms":["Aged","Antihypertensive Agents","Blood Pressure","Diastole","Female","Humans","Hypertension","Male","Netherlands","Prospective Studies","Reference Values","Risk Factors","Systole","Cohort Studies","Comorbidity","Confounding Factors, Epidemiologic","Risk Assessment","Stroke"],"keywords":["Medicine","Blood pressure","Stroke (engine)","Internal medicine","Incidence (geometry)","Prospective cohort study","Cardiology","Stroke risk","Prehypertension","Risk factor","Cohort","Cohort study","Population","Relative risk","Diastole","Ischemic stroke","Confidence interval"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T15:38:53.436487Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}