Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Assessing the applicability of 2017 ACC/AHA hypertension guidelines for secondary stroke prevention in the BOSS study
First author：Xuewei Xie,Hongqiu Gu
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Xuewei Xie,Hongqiu Gu
- Data Sources： BOSS
- Number of papers：BOSS20190919
- Published time：2019-08-29
2019-08-29
Published articles
Journal：Journal of Clinical Hypertension
Publication type: Original Contributions
IF(IF): 3.738
PMID: 31468708 Link To Pubmed Full text Download
Background And Purpose
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.
Method
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.
Conclusion
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.
Main results
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.