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.
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