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- Title
Blood Pressure After Recent Stroke: Baseline Findings From the Secondary Prevention of Small Subcortical Strokes Trial.
- Authors
White, Carole L.; Pergola, Pablo E.; Szychowski, Jeff M.; Talbert, Robert; Cervantes-Arriaga, Amin; Clark, Heather D.; Del Brutto, Oscar H.; Godoy, Ivan Esteban; Hill, Michael D.; Pelegrí, Antoni; Sussman, Craig R.; Taylor, Addison A.; Valdivia, José; Anderson, Dave C.; Conwit, Robin; Benavente, Oscar R.
- Abstract
BACKGROUND Hypertension is the most powerful risk factor for stroke. The aim of this study was to characterize baseline blood pressure in participants in the Secondary Prevention of Small Subcortical Strokes trial. METHODS For this cross-sectional analysis, participants were categorized by baseline systolic blood pressure (SBP) < 120, 120–139, 140–159, 160–179, and ≥ 180mm Hg and compared on demographic and clinical characteristics. Predictors of SBP < 140mm Hg were examined. RESULTS Mean SBP was 143±19mm Hg while receiving an average of 1.7 antihypertensive medications; SBP ≥ 140mm Hg for 53% and ≥ 160 mm Hg for 18% of the 3,020 participants. Higher SBP was associated with a history of hypertension and hypertension for longer duration (both P < 0.0001). Higher SBPs were associated with more extensive white matter disease on magnetic resonance imaging (P < 0.0001). There were significant differences in entry-level SBP when participants were categorized by race and region (both P < 0.0001). Black participants were more likely to have SBP ≥ 140mm Hg. Multivariable logistic regression showed an independent effect for region with those from Canada more likely (odds ratio = 1.7; 95% confidence interval, 1.29, 2.32) to have SBP < 140mm Hg compared with participants from United States. CONCLUSIONS In this cohort with symptomatic lacunar stroke, more than half had uncontrolled hypertension at approximately 2.5 months after stroke. Regional, racial, and clinical differences should be considered to improve control and prevent recurrent stroke. CLINICAL TRIALS REGISTRATION Trial Number NCT00059306
- Subjects
STROKE prevention; HYPERTENSION; LACUNAR stroke; SYSTOLIC blood pressure; WHITE matter (Nerve tissue); ANTIHYPERTENSIVE agents; MAGNETIC resonance imaging; CROSS-sectional method
- Publication
American Journal of Hypertension, 2013, Vol 26, Issue 9, p1114
- ISSN
0895-7061
- Publication type
Article