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Tighter Control of Systolic BP Lowers Stroke Risk for Some

SBP <;130 mm Hg provides additional stroke protection only in those with risk factors but no CVD

THURSDAY, June 23 (HealthDay News) -- Tight control of systolic blood pressure (SBP) to levels of less than 130 mm Hg is associated with additional risk reduction of stroke among people with risk factors but no established cardiovascular disease, according to a meta-analysis published online June 2 in the Annals of Neurology.

Meng Lee, M.D., from the Chang Gung University College of Medicine in Taiwan, and colleagues reviewed the literature to investigate the impact of achieving tight versus usual SBP control on stroke prevention. A total of 11 studies were included, with 42,572 participants and 794 stroke events. Relative risk (RR) was used to compare the pooled risk of stroke in all trials in an intensive treatment group that achieved SBP of less than 130 mm Hg, and a usual treatment group that achieved SBP of 130 to 139 mm Hg.

The investigators found that the final mean SBP was 126.5 mm Hg and 132.6 mm Hg for participants undergoing intensive and conventional treatment, respectively (mean SBP reduction 6.1 mm Hg. A tight SBP level was associated with a significantly reduced risk of stroke (RR, 0.80) and major vascular diseases (RR, 0.91). Following tight SBP control, the future risk of stroke was significantly reduced in patients with the presence of risk factors but in the absence of established cardiovascular disease (RR, 0.49; 95 percent confidence interval [CI], 0.34 to 0.69), while the risk for patients with established cardiovascular disease remained unaffected (RR, 0.92; 95 percent CI, 0.83 to 1.03).

"Achieving an SBP <130 mm Hg compared to 130 to 139 mm Hg appears to provide additional stroke protection only among people with risk factors but no established cardiovascular disease," the authors write.

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