ArticleJournal of global health2025
Long-term systolic blood pressure and cardiovascular risks among patients with ischemic stroke: a register-based cohort study.
Article in Journal of global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Background: The impact of blood pressure fluctuations on the prognosis of stroke has been well documented, but little is known about the association between long-term systolic blood pressure (SBP) levels and the risks of cardiovascular outcomes in patients with ischemic stroke (IS). Methods: In this retrospective cohort study, we included a total of 11 357 eligible IS patients hospitalised in Shenzhen, China between 1 July 2017 and 1 October 2023. One-year levels of SBP after IS patient discharge were identified using group-based trajectory models (GBTM). Propensity score-overlap weighted Cox regression models were used to assess the associations between SBP levels and the risks of recurrent stroke and major adverse cardiovascular events (MACE; including recurrent stroke, ischemic heart disease, and heart failure) within a 36-month follow-up period, respectively. Furthermore, we quantitatively assessed the benefits potentially gained from optimal SBP levels by calculating age-scale restricted mean survival times. Results: Three one-year GBTM-derived SBP level patterns were identified: normal (n = 2120), high-normal (n = 7949), and uncontrolled SBP (n = 1288). During a median follow-up of 1.75 years, IS patients with normal and high-normal SBP were associated with lower risks of recurrent stroke or MACE, with weighted hazard ratios (95% confidence interval (CI)) ranging from 0.68 (95% CI = 0.54-0.86) to 0.89 (95% CI = 0.78-1.02), compared to those with uncontrolled SBP. Furthermore, IS patients aged 45 to 70 years with normal or high-normal SBP may derive greater health benefits, with the event-free survival time ranging from 7.12 to 0.27 years. Conclusions: Maintaining sustained normal or high-normal SBP levels one year after discharge may be associated with a reduced risk of adverse cardiovascular events and potentially yields greater health benefits for IS patients.
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