Research
AHA stroke trials report findings on blood pressure and clot prevention
In OPTIMAL-STROKE, targeting systolic blood pressure below 120 mm Hg reduced cardiovascular events, while kidney-related events were more common.
Three trials presented at the American Heart Association Scientific Sessions examined treatments after stroke, ACC reported. In REDUCE, 160 stroke survivors with high blood pressure were assigned to spironolactone plus their regular medications or usual care. At three months, home-measured systolic blood pressure was approximately 8 mm Hg lower on average with spironolactone, at ~126 mm Hg versus 133 mm Hg. In OCEANIC-STROKE, asundexian reduced ischemic stroke with similar bleeding versus placebo across Framingham Risk Score categories, ACC reported.
OPTIMAL-STROKE compared systolic blood pressure targets of less than 120 mm Hg and less than 140 mm Hg in 4,368 people with high blood pressure and a previous stroke or transient ischemic attack. Over a median 3.9 years, a primary cardiovascular outcome occurred in 10.9% of the intensive-treatment group and 13.5% of the standard-treatment group, according to Healio. The hazard ratio was 0.79.
Healio reported renal outcomes in 3.9% of the intensive-treatment group and 2.2% of the standard-treatment group. Serious adverse events were comparable between groups. ACC said researchers stressed medical supervision and monitoring of kidney function with lower blood pressure targets.
