国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Assessing the applicability of 2017 ACC/AHA hypertension guidelines for secondary stroke prevention in the BOSS study

第一作者：Xuewei Xie,Hongqiu Gu

通讯作者：Yongjun Wang

Ischemic Stroke; Transient Ischemic Attack; Blood

基本信息

2019-08-29

已发表文章

发表杂志：Journal of Clinical Hypertension

发表类型: Original Contributions

影响因子(IF): 3.738

PMID: 31468708 Pubmed原文链接 全文下载

主要研究背景及目的

Using data from the Blood Pressure and Clinical Outcome in TIA or Ischemic Stroke (BOSS) study, we aim to test the applicability and feasibility of stroke secondary prevention recommendations from the 2017 American College of Cardiology /American Heart Association guideline.

方法

Patients were categorized based on their blood pressure (BP) status at 3-month. The non-hypertension group was defined as those without a diagnosis of hypertension. The other patients were further divided into three subgroups according to office BP measured at 3-month visit (BP <130/80, 130-139/80-89 and ≥ 140/90 mmHg). The primary outcome was any stroke within one year. The associations between BP status and 1-year prognosis (recurrent stroke, recurrent stroke/TIA, and poor functional outcome [modified Rankin scale score 3–6]) were estimated.

结论

BP of 130-139/80-89 did not show the worsened clinical outcomes compared with people without hypertension. Our study adds to the growing uncertainty about secondary prevention BP goal for IS/TIA patients.

主要结果

Among 2,341 IS/TIA patients, additional 1,056 patients were classified as uncontrolled hypertension at the 90-day visit according to the new guidelines. Adjusted hazard/odds ratios (95% confidence intervals [CI]) for recurrent stroke in BP <130/80, 130-139/80-89 and ≥ 140/90 compared with non-hypertension group were 2.42 (95% CI: 0.87-6.76), and 4.30 (95% CI: 1.73-10.70) respectively. The prevalence of hypertension and uncontrolled BP among BOSS study population was substantially higher based on the new guidelines.