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Lower systolic blood pressure is associated with poorer survival in long-term survivors of stroke


Kim, J and Gall, SL and Nelson, MR and Sharman, JE and Thrift, AG, Lower systolic blood pressure is associated with poorer survival in long-term survivors of stroke, Journal of Hypertension, 32, (4) pp. 904-911. ISSN 0263-6352 (2014) [Refereed Article]

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Copyright 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

DOI: doi:10.1097/HJH.0000000000000098


BACKGROUND: Lowering blood pressure after stroke reduces the risk of recurrent stroke and other vascular events. However, there is recent evidence that low blood pressure may also result in poor outcome. For the first time, this study aimed to investigate the relationship between blood pressure and outcome in long-term survivors of stroke. METHODS: Participants from the North East Melbourne Stroke Incidence Study were contacted at 5 years after stroke for a follow-up assessment. Blood pressure was measured according to a strict protocol. A multivariable Cox proportional hazards regression model was used to assess the association between SBP measurements at 5 years after stroke and outcome (death, acute myocardial infarction or recurrent stroke) to 10 years after stroke. RESULTS: In 5-year survivors of stroke, compared to a SBP of 131-141 mmHg, a SBP of 120 mmHg or less was associated with a 61% greater risk of stroke, acute myocardial infarction and death (hazard ratio 1.61, 95% confidence interval 1.08-2.41, P = 0.019). Compared to the reference category of SBP 131-141  mmHg, there were no differences in outcome in the patients with SBP 121-130  mmHg (P = 0.491) or 142-210  mmHg (P = 0.313). These findings were not modified when adjusting for prescription of antihypertensive medications. CONCLUSION: There was a greater risk of poor outcome in long-term survivors of stroke with low SBP. This is further evidence that low SBP may result in poor prognosis. Ideal blood pressure levels for long-term survivors of stroke may need to be reassessed.

Item Details

Item Type:Refereed Article
Keywords:blood pressure, epidemiology, outcome, stroke
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Gall, SL (Associate Professor Seana Gall)
UTAS Author:Nelson, MR (Professor Mark Nelson)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:91125
Year Published:2014
Web of Science® Times Cited:22
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-05-08
Last Modified:2017-10-31

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