Intensive or standard blood pressure control in patients with a history of ischemic stroke: RESPECT post hoc analysis

被引：0
作者：
Kazuo Kitagawa
Hisatomi Arima
Yasumasa Yamamoto
Shinichiro Ueda
Hiromi Rakugi
Takahide Kohro
Koji Yonemoto
Masayasu Matsumoto
Takao Saruta
Kazuyuki Shimada
机构：
[1] Tokyo Women’s Medical University,Department of Neurology
[2] Fukuoka University,Department of Prevented Medicine and Public Health, Faculty of Medicine
[3] Kyoto Katsura Hospital,Department of Stroke Center
[4] Faculty of Medicine,Department of Clinical Pharmacology & Therapeutics
[5] University of the Ryukyus,Division of Biostatistics, School of Health Sciences
[6] Department of Geriatric and General Medicine,Department of Internal Medicine
[7] Osaka University Graduate School of Medicine,Cardiovascular Medicine
[8] Department of Cardiovascular Medicine,General of the Hospital
[9] Jichi Medical University,General of the Hospital
[10] Faculty of Medicine,Saitama Medical Center
[11] University of the Ryukyus,General of the Hospital
[12] Ikeda City Hospital,undefined
[13] Keio University School of Medicine,undefined
[14] Shin-Oyama City Hospital,undefined
[15] Shin-Oyama City Hospital,undefined
[16] Shin-Oyama City Hospital,undefined
[17] Tokyo Women’s Medical University,undefined
[18] Kyoto Katsura Hospital,undefined
[19] Fukuoka University Faculty of Medicine,undefined
[20] University of the Ryukyus School of Medicine,undefined
[21] Jichi Medical School,undefined
[22] University of the Ryukyus Faculty of Medicine,undefined
[23] Shin-Oyama City Hospital,undefined
[24] Yokohama Rosai Hospital,undefined
[25] National Hospital Organization Kyushu Medical Center,undefined
[26] Chuo,undefined
[27] Cardio-renal and health research Institute,undefined
[28] Japan Health Care College,undefined
[29] Saitama Medical University International Medical Center,undefined
[30] Minami-Matsuyama Hospital,undefined
[31] Sakai City Medical Center,undefined
[32] Sakai City Medical Center,undefined
[33] Tohoku University School of Medicine,undefined
[34] University of the Ryukyus School of Medicine,undefined
[35] University of the Ryukyus Graduate School of Medicine,undefined
[36] Tokyo Women’s Medical University,undefined
[37] Kyoto Katsura Hospital,undefined
[38] Osaka University Graduate School of Medicine,undefined
[39] National Cerebral and Cardiovascular Center,undefined
[40] Jichi Medical School,undefined
[41] Nara Medical University,undefined
[42] Iwate Medical University,undefined
[43] National Cerebral and Cardiovascular Center,undefined
[44] Ehime University Graduate School of Medicine,undefined
[45] Tokyo Saiseikai Central Hospital,undefined
[46] Okayama University Graduate School of Medicine,undefined
[47] Hanyu General Hospital,undefined
[48] Okayama University Graduate School of Medicine,undefined
[49] Fukuoka University Faculty of Medicine,undefined
[50] Jichi Medical School,undefined
来源：
Hypertension Research | 2022年 / 45卷
关键词：
Blood pressure lowering; Cerebral infarction; Intracerebral hemorrhage; Stroke; Secondary prevention;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
The Recurrent Stroke Prevention Clinical Outcome (RESPECT) Study and its pooled analysis showed that intensive blood pressure (BP) lowering reduced recurrent stroke risk by 22% in patients with a history of stroke. Here, we report the effect of intensive BP lowering on the risk of recurrent stroke subtypes in patients with a history of ischemic stroke. RESPECT was a randomized clinical trial among 1280 people with a history of cerebral infarction or intracerebral hemorrhage. Participants were assigned to the intensive blood pressure control group (blood pressure < 120/80 mmHg) or standard blood pressure control group (blood pressure < 140/90 mmHg). In this post hoc analysis, we analyzed 1074 patients with a history of cerebral infarction. The mean BP at baseline was 140.7/81.4 mmHg. Throughout the follow-up period, the mean BP was 133.4/77.5 (95% CI, 132.7–134.1/76.9–78.2) mmHg in the standard group and 126.7/74.1 (95% CI, 126.0–127.4/73.5–74.8) mmHg in the intensive group. During a mean follow-up of 3.9 years, 78 first recurrent strokes occurred. Intensive treatment tended to reduce overall annual stroke recurrence (1.74% in intensive vs. 2.17% in standard; P = 0.351 by log-rank test) and did not change the risk of ischemic stroke (1.74% vs. 1.75%, P = 0.999) but markedly reduced the risk of hemorrhagic stroke (0.00% vs. 0.39%, P = 0.005). Beneficial effects of intensive BP control were observed for the risk of hemorrhagic stroke in patients with a history of ischemic stroke. The findings of this study indicate the benefit of intensive BP control for patients with a history of ischemic stroke at high risk of hemorrhagic stroke.
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页码：591 / 601
页数：10
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