Abstract
Current guideline recommends intensive blood pressure (BP) control in hypertensive patients, but the appropriate target BP level after ischemic stroke due to intracranial atherosclerotic stenosis remains uncertain. In this randomized, single-blinded trial, patients with symptomatic internal carotid or middle cerebral artery steno-occlusion (>50%) within 7-42 days after index stroke received intensive (target SBP < 120 mmHg) or modest (target SBP < 140 mmHg) BP control from April 2010 to December 2012. The primary outcome was the change in ischemic lesion volume in white matter lesions at the whole forebrain between baseline and 24 weeks as measured from fluid attenuation inversion recovery (FLAIR) images, which was tested in noninferiority test (noninferiority margin of 3 cm). Among 132 patients, follow-up FLAIR images were available in 111 (59 in the intensive and 52 in the moderate BP control groups). After 24 weeks, the SBP in the intensive group was significantly lower (124.6 ± 10.5 mmHg) than in the modest group (132.3 ± 10.6 mmHg). The ischemic lesion volume increased more in the intensive group (4.9 ± 18.3 cm) than the modest group (2.2 ± 8.2 cm), which failed to prove noninferiority. The frequency of new ischemic lesion...Continue Reading
References
May 4, 2002·Stroke; a Journal of Cerebral Circulation·Hernando Rafael
Nov 1, 2003·Stroke; a Journal of Cerebral Circulation·P M RothwellUNKNOWN Carotid Endarterectomy Trialists' Collaboration
Apr 1, 2005·The New England Journal of Medicine·Marc I ChimowitzUNKNOWN Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators
Sep 15, 2005·Circulation·Ernesto L Schiffrin
May 23, 2007·Circulation·Tanya N TuranUNKNOWN Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators
Mar 17, 2010·The New England Journal of Medicine·William C CushmanFaramarz Ismail-Beigi
Nov 3, 2010·Current Cardiology Reviews·José R RomeroViken L Babikian
Jul 30, 2011·Stroke; a Journal of Cerebral Circulation·Sun U KwonJong S Kim
Sep 9, 2011·The New England Journal of Medicine·Marc I ChimowitzUNKNOWN SAMMPRIS Trial Investigators
Jun 4, 2013·Lancet·O R BenaventeJ M Szychowski
Dec 20, 2013·JAMA : the Journal of the American Medical Association·Paul A JamesEduardo Ortiz
Feb 18, 2014·Neurology·William J PowersUNKNOWN COSS Investigators
May 3, 2014·Stroke; a Journal of Cerebral Circulation·Walter N KernanUNKNOWN American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and
Oct 31, 2014·Stroke; a Journal of Cerebral Circulation·James F MeschiaUNKNOWN Council on Hypertension
Dec 18, 2014·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·D WangJ B Jonas
Feb 19, 2015·Journal of Stroke·Louis R Caplan
Nov 10, 2015·The New England Journal of Medicine·UNKNOWN SPRINT Research GroupWalter T Ambrosius
Apr 5, 2016·The New England Journal of Medicine·Eva M LonnUNKNOWN HOPE-3 Investigators
Apr 30, 2016·Neural Regeneration Research·Eri IwasawaTakanori Yokota
Jun 16, 2016·Lancet·Yuki SonodaHiroaki Shimmura
Jul 20, 2016·Lancet·Martin J O'DonnellUNKNOWN INTERSTROKE investigators
Oct 19, 2017·Journal of Stroke·Jong S Kim, Oh Young Bang
Citations
Sep 10, 2020·The Cochrane Database of Systematic Reviews·Luis Carlos SaizLeire Leache
Sep 28, 2018·Current Cardiology Reports·Faisal Rahman, John W McEvoy
May 3, 2019·American Journal of Hypertension·Bum Joon KimDong-Wha Kang
Feb 19, 2021·Journal of Stroke·Xiao-Ling ZhongJin-Tai Yu
May 25, 2021·Stroke; a Journal of Cerebral Circulation·Dawn O KleindorferLinda S Williams