Deans' stroke musings: Blood pressure reduction in acute ischemic stroke according to time to treatment: a subgroup analysis of the China Antihypertensive Trial in Acute Ischemic Stroke trial

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.

Saturday, May 13, 2017

Blood pressure reduction in acute ischemic stroke according to time to treatment: a subgroup analysis of the China Antihypertensive Trial in Acute Ischemic Stroke trial

But this to think about:

Don't go too low with blood pressure in hypertensive CAD patients

Blood pressure reduction in acute ischemic stroke according to time to treatment: a subgroup analysis of the China Antihypertensive Trial in Acute Ischemic Stroke trial

Xu, Tan^a,b; Zhang, Yonghong^a; Bu, Xiaoqing^a,b; Wang, Dali^c; Sun, Yingxian^d; Chen, Chung-Shiuan^b; Wang, Jinchao^e; Peng, Hao^a; Ju, Zhong^f; Peng, Yanbo^g; Xu, Tian^a; Li, Qunwei^h; Geng, Deqinⁱ; Zhang, Jintao^j; Li, Dong^k; Zhang, Fengshan^l; Guo, Libing^m; Wang, Xuemeiⁿ; Cui, Yong^o; Li, Yongqiu^p; Ma, Dihui^q; Zhang, Dongsheng^r; Yang, Guang^s; Gao, Yanjun^t; Yuan, Xiaodong^u; Chen, Jing^b,v; He, Jiang^b,v; on behalf of the CATIS investigators

Journal of Hypertension: June 2017 - Volume 35 - Issue 6 - p 1244–1251

doi: 10.1097/HJH.0000000000001288

ORIGINAL PAPERS: Stroke and cognitive decline

Objective: The optimal time to initiate antihypertensive therapy among patients with acute ischemic stroke remains uncertain. We tested the effects of blood pressure reduction among patients with acute ischemic stroke according to time from onset to initiation of antihypertensive treatment.

Methods: We randomly assigned 4071 acute ischemic stroke patients with elevated SBP to receive antihypertensive treatment or to discontinue all antihypertensive medications during hospitalization. The primary outcome was a combination of death and major disability, and secondary outcomes included the modified Rankin score, recurrent stroke, vascular disease events, and all-cause mortality.

Results: At 24 h after randomization, the differences in SBP reductions were 8.7, 9.5, and 9.6 mmHg between the antihypertensive treatment and control groups among patients receiving treatment within less than 12, 12–23, and 24–48 h after stroke onset, respectively (P < 0.001 in all subgroups). At day 14 or hospital discharge, the primary and secondary outcomes were not significantly different between the treatment and control groups in all subgroups. At the 3-month follow-up, death or major disability [odds ratio (OR) 0.73; 95% confidence interval (CI) 0.55–0.96; P = 0.03], recurrent stroke (OR 0.25; 95% CI 0.08–0.74; P = 0.01), and vascular events (OR 0.41; 95% CI 0.18–0.95; P = 0.04) were significantly reduced in the antihypertensive treatment group only among participants who received treatment between 24 and 48 h.

Conclusion: Blood pressure reduction might reduce 3-month death and major disability and recurrent stroke among patients with acute ischemic stroke who receive antihypertensive treatment between 24 and 48 h after stroke onset.

Trial registration: ClinicalTrials.gov Identifier: NCT01840072