Key result
Consistently controlled blood pressure after ischemic stroke discharge was associated with a lower risk of death or vascular events compared to uncontrolled blood pressure (HR 0.60; 95% CI 0.39-0.97).
Why the study?
To investigate the effect of consistently controlled blood pressure status after discharge on adverse clinical outcomes among ischemic stroke patients.
Does consistently controlled blood pressure and regular use of antihypertensive medication reduce death and vascular events in acute ischemic stroke patients?
Cohort (n=3,406)
Does consistently controlled blood pressure and regular use of antihypertensive medication reduce death and vascular events in acute ischemic stroke patients?
Continuous blood pressure control and regular antihypertensive medication use after discharge significantly reduce mortality and vascular events in ischemic stroke patients.
Answers are grounded in this paper and cite their sources.
Supports consistent post-stroke BP control; extends observational data but leaves causality open for RCTs.
OBJECTIVE: To investigate the effect of consistently blood pressure (BP) control status after discharge on adverse clinical outcomes among ischemic stroke (IS) patients. METHODS: Three thousand, four hundred and six acute IS patients were included and followed up at 3 months, 12 months, and 24 months after stroke. Study outcomes were defined as death, vascular events and composite of death or vascular events. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confident interval (CI) of death and the composite outcome of death or vascular events associated with BP control and antihypertensive medication use. RESULTS: The multivariable adjusted HRs were 0.22 [95% confidence interval (CI): 0.09-0.57] for death and 0.60 (95% CI: 0.39-0.97) for the composite outcome of death or vascular events among participants with consistently controlled BP compared with those with consistently uncontrolled BP. The participants with both consistently controlled BP and regular use of antihypertensive medication had the lowest risks of death [hazard ratio (HR): 0.18, 95% CI: 0.04-0.75] and composite outcome of death or vascular events (HR: 0.54, 95% CI: 0.29-0.98) in comparison with those with both uncontrolled BP and irregular use of antihypertensive medication. DISCUSSION: Continuous BP control and regular use of antihypertensive medications after discharge can decrease the risks of death and composite outcome of death or vascular events among IS patients, suggesting the importance of continuous BP control and regular use of antihypertensive medications after discharge for improving prognosis of IS.
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Shi et al. (2023) conducted a cohort in ischemic stroke (n=3,406). Consistently controlled blood pressure vs. Consistently uncontrolled blood pressure was evaluated on composite outcome of death or vascular events (HR 0.60, 95% CI 0.39-0.97). Consistently controlled blood pressure after ischemic stroke discharge was associated with a lower risk of death or vascular events compared to uncontrolled blood pressure (HR 0.60; 95% CI 0.39-0.97).
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