The angiotensin receptor blocker (ARB) and β-blocker drug classes were associated with incident stroke and ischemic stroke in older adults, according to a study of 5,951 participants with a median age of 74 years taking at least 1 drug for hypertension or with systolic BP >140 mm Hg or diastolic BP >90 mm Hg. Researchers found:

• There were 273 incident strokes over a median 9.1 years.

• Stroke risk was not usually reduced by BP-lowering drugs.

• ARBs (HR=1.56) and β-blockers (HR=1.41) were associated with increased total stroke risk.

• ARBs and β-blockers were also associated with ischemic strokes after adjustments for systolic blood pressure variability (BPV).

• Diastolic BPV was associated with stroke risk in analyses stratified by systolic BP 140 to 160 mm Hg (per 0.10 increase in coefficient of variation HR=1.59).

Citation: Tully PJ, Debette S, Dartigues J-F, Helmer C, Artero S, Tzourio C. Antihypertensive drug use, blood pressure variability, and incident stroke risk in older adults: Three-city cohort study. [Published online ahead of print March 24, 2016]. Stroke. doi:10.1161/STROKEAHA.115.012321.