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Posted by on Jan 18, 2016 in Stroke | 0 comments

In a nutshell

This study aimed to determine what blood pressure level was associated with the lowest risk of stroke, vascular event and all cause mortality. The results showed a level of 120-128mmHg systolic and 65-70mmHg diastolic blood pressure as the lowest risk level for recurrent stroke and major vascular events.

Some background

High blood pressure is a known risk factor for cardiovascular events such as stroke. Guidelines suggest lowering blood pressure (BP) to a specific target with medication to lower risks. However, a lower limit for BP or adverse effects associated with low BP are not often specified.

Systolic blood pressure (SBP, the first number given) is the pressure when the heart is contracting. Diastolic blood pressure (DBP, the second number given) is the pressure when the heart is relaxed. Studies have shown that low DBP and high SBP are associated with cardiovascular events. A link between BP and recurrent stroke, however, has not been studied. 

Methods & findings

This study aimed to determine an overall BP level with the lowest risk of cardiovascular or stroke events. This study also aimed to define a lower limit above which BP should be maintained.

This study looked at 2747 small stroke patients above the age of 30. Each patient had their BP taken at least 6 months after their first stroke and before recurrent stroke, major vascular event or death.

After an average follow up of 3.7 years, the study identified roughly 124 mmHg SBP and 67 mmHg DBP as the lowest level for risk of stroke. BPs both above and below these values led to an increased risk of stroke, major vascular event and mortality. The DBP level was more important in recurrent stroke and major vascular events, however, SBP had a stronger link with all cause mortality.

The lowest risk level for all events was at an SBP of 120-128 mmHg and DBP of 65-70 mmHg.

The bottom line

The study showed that both very low and high BP levels were associated with increased risk of stroke, vascular event, or death.

The fine print

The underlying reasons for this association between BP and stroke are unknown and need to be examined.

What’s next?

Discuss your optimal blood pressure targets with your doctor.

Published By :

Hypertension

Date :

Nov 09, 2015

Original Title :

Achieved Blood Pressure and Outcomes in the Secondary Prevention of Small Subcortical Strokes Trial.

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