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Background: This study investigates the impact of intensive versus standard blood pressure control on mortality and vascular incidents in hypertensive patients with a history of stroke. Objective: The aim is to compare these treatment approaches and understand their potential benefits and risks through a meta-analysis of existing studies. Method: A comprehensive search was conducted across multiple databases, resulting in the inclusion of 11 Randomized Controlled Trial studies and 2 prospective cohort studies. The risk of bias was assessed using RoB 2 tools and the Newcastle-Ottawa Scale. Result: Intensive blood pressure control showed a slightly higher risk of death and other vascular events compared to standard blood pressure control. Intensive blood pressure control has higher risk of death (OR: 1.11, 95% CI: 1.06 – 1.17, I2: 68%). It has a slightly lower risk of Death or Disability (OR: 0.95, 95% CI: 0.86 – 1.04, I 2 : 0%). It has a slightly higher risk of Hematoma Expansion (OR: 1.10, 95% CI: 1.01 – 1.19, I 2 : 72%). It has a slightly higher risk of recurrent stroke (OR: 1.04, 95% CI: 0.98 - 1.10, I 2 : 64%). It has a slightly higher risk of Neurological Detrioration (OR: 1.13, 95% CI: 1.05 - 1.21, I 2 : 3%). It has a lower risk of mRS score (OR: 0.86, 95% CI: 0.84 – 0.88, I 2 : 74%). It has a slightly lower risk of improvement mRS score (OR: 0.90, 95% CI: 0.87 – 0.93, I 2 : 0%). Most of the studies were conducted in multicentre regions and had large sample sizes, which signifies the external validity of this meta-analysis. Conclusion: Intensive blood pressure targets may not be more beneficial than standard ones in reducing the risk of mortality and vascular events. Further studies are needed to validate these findings.
Majidan et al. (Wed,) studied this question.