Intensive blood pressure treatment reduced cardiovascular events after stroke

A randomized trial reported at the American Heart Association Scientific Sessions tested intensive blood pressure treatment in adults with elevated blood pressure and a previous ischemic stroke or transient ischemic attack. Researchers at 30 sites assigned 2,172 participants to a systolic blood pressure target of <120 mmHg and 2,196 to standard treatment targeting <140 mmHg. The study was published online Nov. 7 in the New England Journal of Medicine.

During a median follow-up of 3.9 years, the composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina or heart failure occurred in 10.9% of the intensive-treatment group and 13.5% of the standard-treatment group. Researchers reported a hazard ratio of 0.79. A composite renal outcome, defined as sustained reduction of ≥50% in estimated glomerular filtration rate or progression to end-stage renal disease, was more common with intensive treatment. Gisele Sampaio Silva said lower blood pressure requires medical supervision and additional monitoring, particularly of kidney function.