No protocol so still useless. Hope you like your doctor guessing your treatment needs. ARE YOU THAT CERTAIN PATIENT? HOW THE FUCK DO YOU KNOW IF YOU NEED THIS? My god, the incompetence displayed for all to see.
Immediate antihypertensive treatment after stroke may benefit certain patients
August 10, 2019
Initiating
antihypertensive therapy immediately after acute ischemic stroke reduced
recurrent stroke risk in patients with prior hypertension but did not
affect other outcomes, researchers reported.
The researchers conducted a prespecified subgroup analysis from the CATIS trial of 4,071 patients with acute ischemic stroke and elevated systolic BP (mean age, 62 years; 64% men). The intervention group received shortly after their event an antihypertensive regimen designed to decrease systolic BP by 10% to 25% at 24 hours, to achieve systolic BP less than 140 mm Hg and diastolic BP less than 90 mm Hg at 7 days and to maintain that level throughout hospitalization. The control group had all antihypertensive medication discontinued.
For the present analysis, the results were stratified by whether patients had prior hypertension.
The primary outcome was death or major disability, defined as a modified Rankin Scale score of 3 or greater, at 14 days or hospital discharge.
During the study period, there was no difference in the primary outcome between the approaches, regardless of whether patients had prior hypertension (OR for prior hypertension group = 1; 95% CI, 0.87-1.16; OR for no prior hypertension group = 1; 95% CI, 0.75-1.32; P for homogeneity = .97), Rui Zhang, MD, from the department of epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China, and colleagues wrote.
However, among patients with prior hypertension, recurrent stroke at 3 months was lower in the intervention group than in the control group (OR = 0.44; 95% CI, 0.25-0.77), which was not the case for patients without prior hypertension (OR = 3.43; 95% CI, 0.94-12.55; P for homogeneity = .005).
Vascular events at 3 months were not significantly different between the intervention and control groups (OR for prior hypertension group = 0.66; 95% CI, 0.43-1.02; OR for no prior hypertension group = 1.91; 95% CI, 0.75-4.83; P for homogeneity = .04), according to the researchers.
“This subgroup analysis provides data to support early antihypertensive intervention among patients with ischemic stroke and a history of hypertension, and early treatment could help them transition to long-term antihypertensive therapy for secondary prevention; for patients without prior hypertension, the decision to decrease BP with antihypertensive treatment should be based on individual clinical judgment and requires more caution,” Zhang and colleagues wrote. – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
The researchers conducted a prespecified subgroup analysis from the CATIS trial of 4,071 patients with acute ischemic stroke and elevated systolic BP (mean age, 62 years; 64% men). The intervention group received shortly after their event an antihypertensive regimen designed to decrease systolic BP by 10% to 25% at 24 hours, to achieve systolic BP less than 140 mm Hg and diastolic BP less than 90 mm Hg at 7 days and to maintain that level throughout hospitalization. The control group had all antihypertensive medication discontinued.
The primary outcome was death or major disability, defined as a modified Rankin Scale score of 3 or greater, at 14 days or hospital discharge.
During the study period, there was no difference in the primary outcome between the approaches, regardless of whether patients had prior hypertension (OR for prior hypertension group = 1; 95% CI, 0.87-1.16; OR for no prior hypertension group = 1; 95% CI, 0.75-1.32; P for homogeneity = .97), Rui Zhang, MD, from the department of epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China, and colleagues wrote.
However, among patients with prior hypertension, recurrent stroke at 3 months was lower in the intervention group than in the control group (OR = 0.44; 95% CI, 0.25-0.77), which was not the case for patients without prior hypertension (OR = 3.43; 95% CI, 0.94-12.55; P for homogeneity = .005).
Vascular events at 3 months were not significantly different between the intervention and control groups (OR for prior hypertension group = 0.66; 95% CI, 0.43-1.02; OR for no prior hypertension group = 1.91; 95% CI, 0.75-4.83; P for homogeneity = .04), according to the researchers.
“This subgroup analysis provides data to support early antihypertensive intervention among patients with ischemic stroke and a history of hypertension, and early treatment could help them transition to long-term antihypertensive therapy for secondary prevention; for patients without prior hypertension, the decision to decrease BP with antihypertensive treatment should be based on individual clinical judgment and requires more caution,” Zhang and colleagues wrote. – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
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