{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:45:35Z","timestamp":1791290735557,"version":"4.3.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The focus for reducing hypertension-related cardiovascular disease is the management of blood pressure. Limited data are available on the potential benefit of delaying the onset of hypertension.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Stroke-free Black and White participants from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke; recruited 2003\u20132007) were followed through 2022 for incident stroke events. Participants were stratified by duration of recognized hypertension: normotensive (0 years), \u22645 years, 6 to 20 years, or 21+ years. The baseline systolic blood pressure (SBP), the number of classes of antihypertensive medications, and the risk of incident stroke were assessed by duration strata adjusting for demographics, cerebrovascular risk factors, SBP, and use of antihypertensive medications (where appropriate).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Of 30\u2005239 study participants, we included 27\u2005310 participants (mean age, 65 years; 45% male), followed a median of 12.4 years, during which 1763 incident stroke events occurred. On average, participants with hypertension duration \u22645 years, 6 to 20 years, and 21+ years were taking 1.68 (95% CI, 1.65\u20131.71), 2.04 (95% CI, 2.01\u20132.07), and 2.28 (95% CI, 2.25\u20132.31) classes of antihypertensive medications, respectively. The adjusted mean SBP level was higher with each increasing duration of recognized hypertension (0, \u22645, 6\u201320, and 21+ years): 123.9 mm\u2005Hg (95% CI, 123.3\u2013124.6), 129.7 mm\u2005Hg (95% CI, 129.1\u2013130.2), 131.7 mm\u2005Hg (95% CI, 130.6\u2013131.5), and 132.6 mm\u2005Hg (95% CI, 132.0\u2013133.1). Compared with normotensive individuals, the hazard for incident stroke increased from 1.31 (95% CI, 1.05\u20131.63) for \u22645 years duration, 1.50 (95% CI, 1.21\u20131.87) for 6 to 20 years duration, and 1.67 (95% CI, 1.32\u20132.10) for 21+ years duration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Longer duration of recognized hypertension was associated with more classes of antihypertensive medications, higher mean SBP, and higher stroke risk even after adjustment for age and SBP. Collectively, this suggests that delaying the onset of hypertension could reduce the burden of stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.124.048385","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T10:00:17Z","timestamp":1733738417000},"page":"105-112","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Association of Duration of Recognized Hypertension and Stroke Risk: The REGARDS Study"],"prefix":"10.1161","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3068-5720","authenticated-orcid":true,"given":"George","family":"Howard","sequence":"first","affiliation":[{"name":"Department of Biostatistics (G.H., S.E.J.), School of Public Health, University of Alabama at Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-5492","authenticated-orcid":true,"given":"Paul","family":"Muntner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (P.M., V.J.H.), School of Public Health, University of Alabama at Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5733-6283","authenticated-orcid":true,"given":"Daniel T.","family":"Lackland","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of South Carolina, Charleston (D.T.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9992-9597","authenticated-orcid":true,"given":"Timothy B.","family":"Plante","sequence":"additional","affiliation":[{"name":"Department of Medicine, Larner College of Medicine, University of Vermont, Burlington (T.B.P., M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7871-6143","authenticated-orcid":true,"given":"Mary","family":"Cushman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Larner College of Medicine, University of Vermont, Burlington (T.B.P., M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-9650","authenticated-orcid":true,"given":"Brian","family":"Stamm","sequence":"additional","affiliation":[{"name":"Department of Neurology and National Clinician Scholars Program, University of Michigan, Ann Arbor (B.S.)."},{"name":"Lieutenant Colonel Charles S. Kettles VA Medical Center, Ann Arbor, MI (B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7594-6587","authenticated-orcid":true,"given":"Suzanne E.","family":"Judd","sequence":"additional","affiliation":[{"name":"Department of Biostatistics (G.H., S.E.J.), School of Public Health, University of Alabama at Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4912-9975","authenticated-orcid":true,"given":"Virginia J.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (P.M., V.J.H.), School of Public Health, University of Alabama at Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.07.008"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy877"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.07098"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13551"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.785356"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.009128"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000086678"},{"key":"e_1_3_3_9_2","first-page":"113","article-title":"Cerebrovascular disease in the community: results of a WHO collaborative study.","volume":"58","author":"Aho K","year":"1980","unstructured":"Aho K, Harmsen P, Hatano S, Marquardsen J, Smirnov VE, Strasser T. 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