Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, January 12, 2017

In people using blood pressure–lowering drugs, more-intensive therapy reduces cardiovascular events and strokes more than less-intensive therapy

Your doctor will let you know what intensity means and which way they are taking you.
https://www.mcmasteroptimalaging.org/full-article/es/people-blood-pressure-lowering-drugs-intensive-therapy-reduces-cardiovascular-367

Review question

In people who are prescribed drugs to lower blood pressure, does more-intensive therapy reduce the risk for major cardiovascular events (e.g., heart attack, heart failure) and stroke compared with less-intensive therapy?

Background

People with high blood pressure and some other conditions (e.g., diabetes, kidney disease) are more likely than many other people to have a major cardiovascular event. High blood pressure is usually defined as having a systolic blood pressure (SBP) of 140 mm Hg or more or a diastolic blood pressure (DBP) of 90 mm Hg or more.
Drugs that lower blood pressure can reduce risk for cardiovascular events. More-intensive drug therapy can reduce blood pressure more than less-intensive drug therapy. It may also be better for reducing cardiovascular events but could have more side effects.

How the review was done

The researchers did a systematic review, searching for studies that were published up to November 2015.
They found 18 randomized controlled trials with 44,604 adults (average age 41 to 77 years, 37% to 74% men) and 1 randomized controlled trial with 385 children (average age 12 years, 59% boys).
The key features of the studies were:
  • most people had high blood pressure; some had diabetes, chronic kidney disease, or more than one condition that increased risk for cardiovascular events;
  • drugs were used to reduce blood pressure to specific levels or by specific amounts;
  • more-intensive therapy was compared with less-intensive therapy;
  • more-intensive therapy aimed to reduce blood pressure more than less-intensive therapy; and
  • people were followed up for at least 6 months (3.8 years on average).

What the researchers found

Compared with less-intensive therapy, more-intensive blood pressure–lowering therapy:
  • reduced blood pressure (SBP by 6.8 mm Hg and DBP by 3.5 mm Hg);
  • reduced major cardiovascular events and stroke;
  • had similar rates of death, heart attack, heart failure, and end-stage kidney disease; and
  • had higher rates of severe low blood pressure, which can cause dizziness or fainting, although yearly event rates were low in both groups (0.1% in the lower-intensity group vs 0.3% in the higher-intensity group, with adverse events leading to discontinuation of treatment in 1% for each group).

Conclusion

In people who are prescribed drugs to lower blood pressure, more-intensive therapy reduces cardiovascular events and strokes more than less-intensive therapy.

Table at the link.

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