Letter by Nagai et al Regarding Article, “Antihypertensive Drug Use, Blood Pressure Variability, and Incident Stroke Risk in Older Adults: Three-City Cohort Study”
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To the Editor:
We read the interesting recent article by Tully et al1 who found that the angiotensin receptor blocker (ARB) and β-blocker were associated with incident stroke, whereas long-term visit-to-visit blood pressure (BP) variability was not associated with that in the elderly. The mechanism underlying in the relationship between β-blocker use and increased stroke risk was suggested as compensatory hemodynamic changes associated with decreased heart rate.2 Thus, in the elderly, increased aortic stiffness and pressure wave reflection lead to increased central aortic pressures with β-blocker use.2 On the other hand, there were less explanations for the relationship between …