Featured Research

from universities, journals, and other organizations

Study evaluates 'normal range' systolic blood pressure levels after ischemic stroke and risk of recurrent stroke

Date:
November 27, 2011
Source:
JAMA and Archives Journals
Summary:
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 new study.

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 Nov. 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.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Bruce Ovbiagele, Hans-Christophe Diener, Salim Yusuf, Reneι H. Martin, Daniel Cotton, Richard Vinisko, Geoffrey A. Donnan, Philip M. Bath, for the PROFESS Investigators. Level of Systolic Blood Pressure Within the Normal Range and Risk of Recurrent Stroke. JAMA, 2011; 306 (19): 2137-2144 DOI: 10.1001/jama.2011.1650

Cite This Page:

JAMA and Archives Journals. "Study evaluates 'normal range' systolic blood pressure levels after ischemic stroke and risk of recurrent stroke." ScienceDaily. ScienceDaily, 27 November 2011. <www.sciencedaily.com/releases/2011/11/111115094608.htm>.
JAMA and Archives Journals. (2011, November 27). Study evaluates 'normal range' systolic blood pressure levels after ischemic stroke and risk of recurrent stroke. ScienceDaily. Retrieved September 1, 2014 from www.sciencedaily.com/releases/2011/11/111115094608.htm
JAMA and Archives Journals. "Study evaluates 'normal range' systolic blood pressure levels after ischemic stroke and risk of recurrent stroke." ScienceDaily. www.sciencedaily.com/releases/2011/11/111115094608.htm (accessed September 1, 2014).

Share This




More Health & Medicine News

Monday, September 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

We've Got Mites Living In Our Faces And So Do You

We've Got Mites Living In Our Faces And So Do You

Newsy (Aug. 30, 2014) — A new study suggests 100 percent of adult humans (those over 18 years of age) have Demodex mites living in their faces. Video provided by Newsy
Powered by NewsLook.com
Liberia Continues Fight Against Ebola

Liberia Continues Fight Against Ebola

AFP (Aug. 30, 2014) — Authorities in Liberia try to stem the spread of the Ebola epidemic by raising awareness and setting up sanitation units for people to wash their hands. Duration: 00:41 Video provided by AFP
Powered by NewsLook.com
California Passes 'yes-Means-Yes' Campus Sexual Assault Bill

California Passes 'yes-Means-Yes' Campus Sexual Assault Bill

Reuters - US Online Video (Aug. 30, 2014) — California lawmakers pass a bill requiring universities to adopt "affirmative consent" language in their definitions of consensual sex, part of a nationwide drive to curb sexual assault on campuses. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
New Drug Could Reduce Cardiovascular Deaths

New Drug Could Reduce Cardiovascular Deaths

Newsy (Aug. 30, 2014) — The new drug from Novartis could reduce cardiovascular deaths by 20 percent compared to other similar drugs. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins