Blood pressure after recent stroke: Baseline findings from the secondary prevention of small subcortical strok

Carole L. White, Pablo E. Pergola, Jeff M. Szychowski, Robert Talbert, Amin Cervantes-Arriaga, Heather D. Clark, Oscar H. Del Brutto, Ivan Esteban Godoy, Michael D. Hill, Antoni Pelegrí, Craig R. Sussman, Addison A. Taylor, José Valdivia, Dave C. Anderson, Robin Conwit, Oscar R. Benavente

Research output: Contribution to journalArticle

19 Scopus citations

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 ≥ 180 mm Hg and compared on demographic and clinical characteristics. Predictors of SBP < 140 mm Hg were examined. Results Mean SBP was 143 - 19 mm Hg while receiving an average of 1.7 antihypertensive medications; SBP ≥ 140 mm 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 ≥ 140 mm 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 < 140 mm 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.

Original languageEnglish (US)
Pages (from-to)1114-1122
Number of pages9
JournalAmerican Journal of Hypertension
Volume26
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • blood pressure
  • blood pressure control
  • ethnicity
  • hypertension
  • ischemic stroke
  • lacunar stroke
  • risk factors
  • stroke prevention
  • white matter disease

ASJC Scopus subject areas

  • Internal Medicine

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    White, C. L., Pergola, P. E., Szychowski, J. M., Talbert, R., Cervantes-Arriaga, A., Clark, H. D., Del Brutto, O. H., Godoy, I. E., Hill, M. D., Pelegrí, A., Sussman, C. R., Taylor, A. A., Valdivia, J., Anderson, D. C., Conwit, R., & Benavente, O. R. (2013). Blood pressure after recent stroke: Baseline findings from the secondary prevention of small subcortical strok. American Journal of Hypertension, 26(9), 1114-1122. https://doi.org/10.1093/ajh/hpt076