Deans' stroke musings: Antihypertensive drug use, blood pressure variability, and incident stroke risk in older adults

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, May 1, 2017

Antihypertensive drug use, blood pressure variability, and incident stroke risk in older adults

Obviously not written for the layperson, no fucking clue what this means. Ask your doctor.
https://www.mdlinx.com/internal-medicine/medical-news-article/2016/04/27/antihypertensive-blood-pressure-variability-hypertension-ischemic/6644672/?
The aim was to determine the association between antihypertensive drug class and incident stroke controlling for long–term blood pressure (BP) variability (BPV) in people aged ≥65 years. The angiotensin receptor blocker and β–blocker drug classes were associated with incident stroke and ischemic stroke in older adults. BPV was generally not associated with incident stroke.

Methods

The sample included 5951 participants (median age 74 years, 60% women) taking at least 1 drug for hypertension (3727/5951) or with systolic BP >140 mm Hg or diastolic BP >90 mm Hg.
Participants were evaluated for incident fatal and nonfatal stroke to 12 years follow-up.
BPV was calculated with the coefficient of variation method and regressed against 9 antihypertensive drug classes (BPV_reg).
Hazard models were used to determine hazard ratios for incident stroke risk attributable to drug class, adjusted for BP, BPV_reg, covariates, and delayed entry bias.

Results

There were 273 incident strokes over a median of 9.1 years (interquartile range 6.4-10.4).
Stroke risk was generally not reduced by BP-lowering drugs.
Angiotensin receptor blockers (hazard ratio 1.56; 95% confidence interval 1.06-2.28; P=0.02) and β-blockers (hazard ratio 1.41; 95% confidence interval 1.03-1.92; P=0.03) were associated with an increased total stroke risk.
Angiotensin receptor blockers and β-blockers were also associated with ischemic strokes after adjustment for systolic BPV.
Diastolic BPV was associated with stroke risk in analyses stratified by systolic BP 140 to 160 mm Hg (per 0.10 increase in coefficient of variation, hazard ratio 1.59; 95% confidence interval 1.05–2.40; P=0.03).