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Real-world analysis of two ischaemic stroke and TIA systolic blood pressure goals on 12-month mortality and recurrent vascular events

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Stroke & Vascular Neurology 2024年第5期9卷 519-529页

作者： Jason J Sico Xin Hu Laura J Myers Deborah Levine Dawn M Bravata greg w arling Internal Medicine and Neurology Yale University School of MedicineNew HavenConnecticutUSA Department of Neurology Veterans Affairs Connecticut Healthcare SystemWest HavenConnecticutUSA Yale School of Public Health New HavenConnecticutUSA VA Health Services Research and Development(HSR&D)Center for Healthcare Informatics and Communication and the HSR&D Stroke Quality Enhancement Research Initiative(QUERI) IndianapolisIndianaUSA Richard L.Roudebush VA Medical Center IndianapolisIndianaUSA Departments of Medicine and Neurology University of Michigan School of MedicineAnn ArborMichiganUSA Health Services Research and Development(HSR&D)Center for Healthcare Informatics and Communication and the HSR&D Stroke Quality Enhancement Research Initiative(QUERI) Department of Veterans Affairs(VA) Health Services Research and Development(HSR&D)Precision Monitoring to Transform Care(PRISM)Quality Enhancement Research Initiative(QUERI)IndianapolisIndianaUSA Department of Nursing Purdue UniversityWest LafayetteIndianaUSA

Introduction whether obtaining the more intensive goal systolic blood pressure(SBP)of140mm Hg).Separate multivariable Cox proportional hazard regressions were used to examine the relationship between average SBP group... 详细信息

Introduction whether obtaining the more intensive goal systolic blood pressure(SBP)ofwith incremental mortality and recurrent vascular event benefit is largely unexplored using real-world *** SBP excessively may result in poorer *** This is a retrospective cohort study of 26368 Veterans presenting to a Veterans Administration Medical Center(VAMC)with a stroke/TIA between October 2015 and July *** were excluded from the study if they had missing or extreme BP values,receiving dialysis or palliative care,left against medical advice had a cancer diagnosis,were cared for in a VAMC enrolled in a stroke/TIA quality improvement initiative,died or had a cerebrovascular or cardiovascular event within 90 days after their index stroke/*** analytical sample included 12337 *** SBP during 90 days after discharge was assessed in categories(≤105mm Hg,106–115mm Hg,116–130mm Hg,131–140mm Hg and>140mm Hg).Separate multivariable Cox proportional hazard regressions were used to examine the relationship between average SBP groups and time to:(1)mortality and(2)any recurrent vascular event,from 90 days to up to 365 days after discharge from the index emergency department visit or inpatient *** Compared with those with SBP>140mm Hg,patients with SBP between 116 and 130mm Hg had a significantly lower risk of recurrent stroke/TIA(HR 0.77,95%CI 0.60 to 0.99)but not cardiovascular *** with SBP lower than 105mm Hg,compared with those with>140mm Hg demonstrated a statistically significant higher risk of death(HR 2.07,95%CI 1.43 to 3.00),but no statistical differences were found in other SBP *** Data support a more intensive SBP goal to prevent recurrent cerebrovascular events among stroke/TIA patients by 90 days poststroke/TIA compared with less intensive *** low SBPs were associated wit

关键词： dialysis diagnosis TIA

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