The Framingham Study taught us much about cardiovascular disease in man. Another interesting aspect of this study was recently brought to the attention of physicians by Kannel et al.1 They studied the evolution of atherothrombotic brain infarction in a cohort of 5,209 men and women over a period of 18 years. The results ascertained that hypertension was the most common and most powerful precursor of brain infarction. The authors also compared the influence of the various components of blood pressure on the development of brain infarction. They evaluated the influence of systolic and diastolic pulse, mean arterial pressure, tension-time index, and lability or stability of pressure. In fact, all of these components were associated with the incidence of brain infarction; however, systolic pressure alone emerged as the best indicator of brain infarction risk.
Of 105 infarctions diagnosed during the follow-up of 18 years, only ten occurred in normotensive persons.
Danilevicius Z. Brain Infarction and Blood Pressure. JAMA. 1976;236(13):1501. doi:10.1001/jama.1976.03270140053028
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