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August 23/30, 2000

Blood Pressure Levels and Risk of Stroke in Elderly Patients

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(8):959-960. doi:10.1001/jama.284.8.956

To the Editor: Dr Silvestrini and colleagues1 reported a positive association between cerebral vasoreactivity and risk of stroke in patients with asymptomatic carotid artery stenosis of at least 70%. Previously, stroke risk has been thought to increase linearly with increasing blood pressure (BP). However, 2 recent studies2,3 have suggested that there may be a J-curve relationship between BP level and stroke risk in elderly people so that not only is there an increase in stroke risk with increasing BP level, but also an increasing risk below some specific BP value.