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

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.


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

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