Navigation Links
Study evaluates 'normal range' systolic bp levels after ischemic stroke and risk of recurrent stroke
Date:11/15/2011

CHICAGO Among patients who experienced an ischemic stroke, systolic blood pressure levels of less than 120 mm Hg, or higher than 140 mm Hg, were associated with an increased risk of subsequent stroke, according to a study appearing in the November 16 issue of JAMA, a theme issue on cardiovascular disease. This issue is being released early online to coincide with the American Heart Association Scientific Sessions.

"Recurrent stroke prevention guidelines suggest that larger reductions in systolic blood pressure (SBP) are positively associated with a greater reduction in the risk of recurrent stroke and define an SBP level of less than 120 mm Hg as normal. However, the association of SBP maintained at such levels with risk of vascular events after a recent ischemic stroke is unclear," according to background information in the article.

Bruce Ovbiagele, M.D., M.Sc., of the University of California, San Diego, and colleagues evaluated the association of SBP maintained within a low-normal range vs. high-normal range with clinical outcomes among patients who recently experienced an ischemic stroke. The study consisted of an observational analysis of a multicenter trial involving 20,330 patients (age 50 years or older) with recent non-cardioembolic (not due to small blood clots originating within the heart) ischemic stroke from who were recruited from 695 centers in 35 countries from September 2003 through July 2006 and followed up for 2.5 years (follow-up ended in February 2008). Patients were categorized based on their average SBP level: very low-normal (less than 120 mm Hg), low-normal (120 to less than 130 mm Hg), high-normal (130 to less than 140 mm Hg), high (140 to less than 150 mm Hg), and very high (150 mm Hg or greater).

Occurrence of the primary measured outcome (stroke) was greatest in the very high SBP level group (14.1 percent), followed by the high SBP group (8.7 percent), the very low-normal SBP group (8.0 percent), the low-normal SBP group (7.2 percent), and then the high-normal SBP group (6.8 percent). Occurrence of the secondary outcome (stroke, heart attack, or vascular death) followed a similar pattern. Rates of all-cause mortality and death due to vascular causes were highest in the very low-normal SBP group and very high SBP group.

The analyses revealed that compared with the high-normal SBP level group, the risk of stroke was significantly higher in the very low-normal SBP group, in the high SBP group, and in the very high SBP group. "Compared with the high-normal SBP level group, risks of the secondary outcome were significantly higher in the very low-normal SBP group, in the low-normal SBP group, in the high SBP group, and in the very high SBP group," the authors write.

"Our results indicate that there may indeed be thresholds of benefit or harm with regard to short-term to longer-term SBP levels after a recent non-cardioembolic ischemic stroke, and imply that clinicians regularly caring for stroke patients in the outpatient setting may need to be vigilant about how low a given patient's BP is within the normal range to promote favorable outcomes."

"In conclusion, these data are hypothesis generating and the notion that aggressively and consistently lowering BP levels within the normal range in the short term to longer term after an index ischemic stroke is not beneficial remains unproven, and will require the conduct of dedicated clinical trials comparing intensive with usual BP reduction in the stable follow-up period after a stroke," the authors write. They add that, in the meantime, the results of this analysis support aiming for consistent SBP levels of less than 140 mm Hg and less than 90 mm Hg for diastolic blood pressure among recent ischemic stroke patients.


'/>"/>

Contact: Scott LaFee
slafee@ucsd.edu
619-543-6163
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Despite Treatment, Employees with Depression Generate Higher Absentee Costs, According to Thomson Reuters Study
2. American Council on Exercise (ACE) Study Reveals Kettlebells Provide Powerful Workout in Short Amount of Time
3. TV drama can be more persuasive than news program, study finds
4. Study carried out into biological risks of eating reptiles
5. Neuroimaging study may pave way for effective Alzheimers treatments
6. Study finds racial gaps continue in heart disease awareness
7. Luth Researchs IndicatorEDG(TM) Study Finds Americans Hopes of Achieving Their Dreams Are Fading
8. First blinded study of venous insufficiency prevalence in MS shows promising results
9. Soothing infants with food focus of childhood obesity study
10. People with anxiety disorder less able to regulate response to negative emotions, study shows
11. American Heart Association Rapid Access Journal Report: Study Finds Racial Gaps Continue in Heart Disease Awareness, Low Knowledge of Heart Attack Warning Signs Among Women
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/8/2016)... ... 08, 2016 , ... Joshua Rosenthal, PhD, Chief Scientific Officer ... use newly released government data on populations and physicians to better calculate risk ... the value they create to succeed in new economic models for value based ...
(Date:2/8/2016)... ... February 08, 2016 , ... The schedule is now online for ... 2016 Conference, which is being held May 25-29 at the Loews Chicago O’Hare Hotel, ... interventions and causes of chronic illness in children. , Very recent articles have cited ...
(Date:2/7/2016)... Lake Orion, Clarkston, Metamora, Michigan (PRWEB) , ... ... ... ability to correct pelvic organ prolapse with the latest techniques and the most ... greatest risk for pelvic organ prolapse, particularly after menopause. Other risk factors include ...
(Date:2/7/2016)... ... February 07, 2016 , ... HealthSmart Holdings, Inc. ... organizations with the tools and information to lower the costs, and increase the ... cost of providing employee healthcare benefits by as much as 22%:, + ...
(Date:2/6/2016)... ... February 06, 2016 , ... ... NURSES EXPECTED AT AORN SURGICAL CONFERENCE & EXPO , WHAT:     , This ... an estimated 5000 perioperative nurses in attendance to study the latest evidence-based ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... , Feb. 4, 2016 Worldwide Radiology ... significant growth as next generation systems provide a ... radiology for cancer surgery. New systems pinpoint the ... that has been such a problem previously, limiting ... Radiosurgery robots take cancer surgery far beyond what ...
(Date:2/4/2016)... LONDON , Feb. 4, 2016 ... Summary Global Markets Direct,s, ,Wegener Polyangiitis - ... the Wegener Polyangiitis,s therapeutic pipeline. This report ... Wegener Polyangiitis, complete with comparative analysis at various ... action (MoA), route of administration (RoA) and molecule ...
(Date:2/4/2016)... , Feb. 4, 2016 Global ... competitive market to drive long-term market growth ... common set of chronic disorders that affect 5–7% ... in terms of their symptoms and key patient ... dysregulation of immune pathways and an inappropriate immune ...
Breaking Medicine Technology: