Consistent BP Improves Post-Stroke Outcomes
Amytis Towfighi, MD, from the University of Southern California in Los Angeles, and colleagues conducted a post-hoc analysis of 3,680 individuals from the Vitamin Intervention for Stroke Prevention Trial with recent stroke (<120 days) who were followed for two years. Participants were categorized according to the proportion of visits in which blood pressure was controlled (<140/90mm Hg).
The researchers found that controlled BP was achieved by 30% of participants ≥75% of the time. For individuals with baseline systolic BP >132mm Hg, consistency of BP control affected outcomes. For individuals with baseline systolic BP >75th percentile (>153mm Hg), lower risks of primary (stroke) and secondary (stroke, myocardial infarction, or vascular death) outcomes were seen for those with BP controlled at ≥75% vs. <25% of visits (adjusted hazard ratios, 0.46 and 0.51, respectively). The risks of primary and secondary outcomes were lower for those with mean follow-up BP of <140/90mm Hg versus ≥140/90mm Hg (adjusted hazard ratios, 0.76 and 0.76).
"Fewer than one-third of patients with stroke had BP controlled ≥75% of the time for two years," the authors write. "Consistency of BP control among those with elevated baseline systolic BP was linked to reduction in risk of recurrent stroke and stroke, myocardial infarction, and vascular death."