Intensive or standard blood pressure control in patients with a history of ischemic stroke: RESPECT post hoc analysis

医学 血压 冲程(发动机) 析因分析 内科学 脑梗塞 重症监护 脑出血 随机对照试验 心脏病学 麻醉 缺血 重症监护医学 蛛网膜下腔出血 机械工程 工程类
作者
Kazuo Kitagawa,Hisatomi Arima,Yasumasa Yamamoto,Shinichiro Ueda,Hiromi Rakugi,Takahide Kohro,Koji Yonemoto,Masayasu Matsumoto,Takao Saruta,Kazuyuki Shimada,Kazuyuki Shimada,Kazuyuki Shimada,Kazuo Kitagawa,Yasumasa Yamamoto,Hisatomi Arima,Shinichiro Ueda,Takahide Kohro,Koji Yonemoto,Kazuyuki Shimada,Satoshi Umemura,Yasushi Okada,Genjiro Kimura,Kazuaki Shimamoto,N Tanahashi,Jitsuo Higaki,Masayasu Matsumoto,Masayasu Matsumoto,Sadayoshi Ito,Shinichiro Ueda,Yumiko Ohya,Kazuo Kitagawa,Yasumasa Yamamoto,Hiromi Rakugi,Kazuo Minematsu,Satoshi Hoshide,Yoshihiko Saito,Yasuo Terayama,Ḱazunori Toyoda,Takafumi Okura,Haruhiko Hoshino,Hirofumi Makino,Katsumi Eguchi,Haruhito A. Uchida,Hisatomi Arima,Takahide Khoro,Koji Yonemoto,Shinichiro Uchiyama,Hideki Etani,Tatsuo Kohriyama,Hidekazu Tomimoto,Taku Yoshio,Takao Saruta,Shotai Kobayashi,Hiroko Usami,Satoshi Iihoshi,Tatsuya Mikami,Nobuhiro Mikuni,Kei Miyata,Tomohiro Murakami,Hideki Endo,Takahito Fukui,Kentaro Fumoto,Keiji Hara,Kaori Honjo,Kenji Kamiyama,Yusuke Kinoshita,Masana Maeda,Masaaki Mikamoto,Daisuke Mori,Takeo Murahashi,Ryota Nomura,Shusaku Noro,T. Ogino,Masahiro Okuma,Yuriko Otake,Koichiro Shindo,Hironori Sugio,Hidekazu Takada,Kazuki Takahira,Akiko Takeuchi,Toshiichi Watanabe,Yohei Yamaguchi,Takeo Abumiya,Kiyohiro Houkin,Shigeki Matsumura,Tomohiro Murakami,Rikiya Shinohe,Kiyomi Kuroshima,Katsumi Takizawa,Kazuto Yoshida,Hideo Morimoto,Naoyuki Hasebe,Satoshi Koyama,Junichi Maruyama,Shinsuke Irie,Takahiro Nakano,Yukari Ogasawara,Hiroki Ohkuma,Kazuo Shibanai,Kentaro Hikichi,Shígeo Kobayashi,Junta Moroi,Taizen Nakase,Takeshi Okada,Daiki Takano,Shunsuke Takenaka,Shinji Yoshioka,Toshiharu Yanagisawa,Yoshiki Hirata,Shu Konno,Toshio Sato,Minami Ito,Rei Kondo,Wataru Mori,Shinjiro Saito,Yasuaki Kokubo,Hiroyuki Kato,Hideki Oyama,Kaneyuki Matsuo,Masahiro Matsumoto,Mari Nakamura,Takayuki Koizumi,Hiroyuki Sato,Yasushi Shibata,Katsumi Eguchi,Satoshi Hoshide,Masaaki Hashimoto,Katsumi Eguchi,Hideharu Kurita,Eiji Matsumoto,Kimiko Ishiguro,Ken Asakura,Hiroya Fujimaki,Kazuki Wakabayashi,Kazunori Akaji,Tomo Horikoshi,Tadashige Kano,Takao Kanzawa,Takehiro Katano,Hiroaki Kimura,Ban Mihara,Kentaro Suzuki,Yoshiaki Takayama,Akira Ishii,Sin-ichi Momomura,Hitoshi Sugawara,Takeshi Yamashita,Uichi Kaneko,Toshie Takahashi,Toshinari Arai,Yoshihiro Tanaka,Shigehisa Inokuma,Yukio Kato,N Tanahashi,Naoki Ishige,Kohei Muramatsu,Shigeru Nogawa,Takahito Yoshizaki,Takashi Ohashi,Satoshi Suda,/ Tokyo,Yasuyuki Iguchi,Hidetaka Mitsumura,Tomohide Adachi,Haruhiko Hoshino,Fumie Konoeda,Koichi Oki,Ryota Tanaka,Takao Urabe,Kazuo Yamashiro,Akihiro Ito,Hirofumi Nakatomi,Masaaki Shojima,Kuniaki Otsuka,Koichi Shibata,Takato Abe,Yoshiaki Itoh,Koichi Oki,Norihiro Suzuki,Kazuo Kitagawa,Sono Toi,Tamio Teramoto,Atsushi Fukunaga,Yuki Kujuro,Kouichi Ohta,Takashi Osada,Katsuyoshi Shimizu,Yasuhisa Kitagawa,Kentaro Tokuoka,Masao Omura,Hideyuki Kikyo,Tomoya Kamide,Yoshihisa Kitamura,Katsuyoshi Miyashita,Kentaro Mori,Hiroshi Shima,Akira Tamase,Tsugio Akutsu,Kazutoshi Nishiyama,Shunya Takizawa,Tsuyoshi Uesugi,Uichi Ikeda,Megumi Koshikawa,Saeko Yamasaki,Atsushi Inoue,Y. Matsumoto,Kazuyoshi Yamaguchi,Genjiro Hirose,Satoshi Kontani,Kazuya Takasawa,Katsumi Hirahara,Makoto Kodama,Nobue Yagihara,Takashi Hata,Makoto Hori,Rokuhei Oda,Akihito Kubo,S. Okuda,Kazuo Yamada,Hiroki Takeuchi,Yoshio Araki,Mizuki Ito,Joe Senda,Toshihiko Wakabayashi,Shinji Ito,Tatsuro Mutoh,Yukinori Kawase,Fumihiko Ando,Shin Okamoto,Takehiko Shimada,Akihiro Shindo,Masakatsu Nishikawa,Atsushi Niwa,Ryogen Sasaki,Akihiro Shindo,Hidekazu Tomimoto,Hiroto Murata,Kenichiro Yata,Koushun Matsuo,Hideo Yano,Toshiyuki Shiogai,Yoshinari Nagakane,Yasumasa Yamamoto,Jun Fujinami,Masanori Nakagawa,Reiko Ohara,Yasushi Tomii,Yoshiki Arakawa,Takeshi Funaki,Masafumi Ihara,Akihiro Kitamura,Takakuni Maki,Susumu Miyamoto,Yoshifumi Nakaya,Ryōsuke Takahashi,Yohei Takenobu,Kazumichi Yoshida,Tadashi Ino,Nagako Murase,Ryo Ohotani,Yasushi Tomii,Yasumasa Yamamoto,Atsushi Kawashima,Akiko Watanabe,Yuko Hayashi,Takuma Ohmichi,Rei Yasuda,Akira Yoshioka,N Yuki,Masahiro Makino,Yasushi Tomii,T Yamaguchi,Jyo Matsuzaki,Hiroshi Niki,Shoichi Shiraishi,Takehiko Yanagihara,Keiichi Yamada,Jun Hatate,Kaori Miwa,Shuhei Okazaki,Shoji Arihiro,Ryosuke Doijiri,Kazuhiro Higashida,Kan Kajimoto,Kotaro Miyashita,Kazuyuki Nagatsuka,Kozue Saito,Yuri Sugiura,Hotake Takizawa,Takako Torii,Ḱazunori Toyoda,Chiaki Yokota,Yoshinaga Kajimoto,Toshihiko Kuroiwa,Ryuzo Fukunaga,Tsutomu Takahashi,Kazuhisa Nakao,Yuta Kajiyama,Yasuyoshi Kimura,Takashi Naka,Hironori Otomune,Takao Tanahashi,Takuya Uehara,Hiroyuki Hashimoto,Toshihiko Uematsu,Keisuke Kataoka,Satoshi Okayama,Satoshi Somekawa,Shuichi Yamada,Rie Sasaki,Shigeru Yamano,Naoyuki Nakao,Shinji Obayashi,Hirotoshi Hamaguchi,Tatsushi Toda,Kazuo Washida,Taku Hoshi,Tomoyuki Kono,Hiroaki Sekiya,Norifumi Sugo,Kenichi Todo,Masaya Togo,Hiroshi Yamagami,Shiro Yamamoto,Yoshihiko Shiro,Norifumi Sugo,Hirotoshi Hamaguchi,Toshio Takaoka,Satoshi Abe,Chizuko Hamada,Masaki Ishihara,Koichiro Kadota,Tsuguhiko Nakagawa,Hiroaki Oguro,Hiroyuki Takayoshi,Takuya Yamaguchi,Shuuhei Yamaguchi,Ryo Mizuhara,Kazunori Okada,S Yamagata,Kazunori Okada,Akira Sasaki,Mami Takemoto,Kentaro Deguchi,Shoko Deguchi,Yumiko Nakano,Satoshi Hirai,Masaaki Uno,Kimihiko Yokosuka,Yasuhiro Manabe,Hidetaka Ito,Shiro Aoki,Naohisa Hosomi,Yasuki Kihara,Tomohiko Kisaka,Hirofumi Makino,Masayasu Matsumoto,Hayato Araki,Ryo Ogami,Tsuyoshi Torii,Noboru Yokoyama,Takakazu Yokoyama,Satoshi Kataoka,Τakeshi Kitamura,Takashi Kanda,Toshihiko Maeda,Fumitaka Shimizu,Kozaburo Seki,Yuko Bando,Masaki Ohara,Masahiro Yamasaki,Noritaka Masahira,Tetsuya Ueba,Yusuke Ueba,Norio Sunami,Yuichi Fujimoto,Keiko Haro,Hidenori Ogata,Norihiko Shida,Takeshi Matsumoto,Kensho Okamoto,Jitsuo Higaki,Takafumi Okura,Ryuichi Kawamoto,Shuji Arakawa,Shoji Arihiro,Hirofumi Shii,Hidetoshi Kanai,Shigeru Fujimoto,Juro Jinnouchi,Takayuki Matsuki,Masato Osaki,Kimika Arakawa,Ai Ibaraki,Kanako Kiyohara,Yuko Ohta,Hideyuki Oniki,Minako Sakaki,Mitsuhiro Tominaga,Takuya Tsuchihashi,Saho Higashi,Harunori Ishikawa,Koji Ishitsuka,Jiro Kitayama,Hiroshi Nakane,T. Yoshimura,Shunsuke Kakino,Y Kaneko,Junnosuke Inoue,Yoshikazu Maruyama,Katsunori Isa,Yumiko Ohya,Hirokuni Sakima,Seigo Nakada
出处
期刊:Hypertension Research [Springer Nature]
卷期号:45 (4): 591-601 被引量:6
标识
DOI:10.1038/s41440-022-00862-y
摘要

The Recurrent Stroke Prevention Clinical Outcome (RESPECT) Study and its pooled analysis showed that intensive blood pressure (BP) lowering reduced recurrent stroke risk by 22% in patients with a history of stroke. Here, we report the effect of intensive BP lowering on the risk of recurrent stroke subtypes in patients with a history of ischemic stroke. RESPECT was a randomized clinical trial among 1280 people with a history of cerebral infarction or intracerebral hemorrhage. Participants were assigned to the intensive blood pressure control group (blood pressure < 120/80 mmHg) or standard blood pressure control group (blood pressure < 140/90 mmHg). In this post hoc analysis, we analyzed 1074 patients with a history of cerebral infarction. The mean BP at baseline was 140.7/81.4 mmHg. Throughout the follow-up period, the mean BP was 133.4/77.5 (95% CI, 132.7-134.1/76.9-78.2) mmHg in the standard group and 126.7/74.1 (95% CI, 126.0-127.4/73.5-74.8) mmHg in the intensive group. During a mean follow-up of 3.9 years, 78 first recurrent strokes occurred. Intensive treatment tended to reduce overall annual stroke recurrence (1.74% in intensive vs. 2.17% in standard; P = 0.351 by log-rank test) and did not change the risk of ischemic stroke (1.74% vs. 1.75%, P = 0.999) but markedly reduced the risk of hemorrhagic stroke (0.00% vs. 0.39%, P = 0.005). Beneficial effects of intensive BP control were observed for the risk of hemorrhagic stroke in patients with a history of ischemic stroke. The findings of this study indicate the benefit of intensive BP control for patients with a history of ischemic stroke at high risk of hemorrhagic stroke.
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