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PubMed

Záznam pochází z PubMed

Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials

Katsanos, Aristeidis H
Autor Katsanos, Aristeidis H From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Filippatou, Angeliki
Autor Filippatou, Angeliki From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Manios, Efstathios
Autor Manios, Efstathios From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Deftereos, Spyridon
Autor Deftereos, Spyridon From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Parissis, John
Autor Parissis, John From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Frogoudaki, Alexandra
Autor Frogoudaki, Alexandra From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Vrettou, Agathi-Rosa
Autor Vrettou, Agathi-Rosa From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Ikonomidis, Ignatios
Autor Ikonomidis, Ignatios From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Pikilidou, Maria
Autor Pikilidou, Maria From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Kargiotis, Odysseas
Autor Kargiotis, Odysseas From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Voumvourakis, Konstantinos
Autor Voumvourakis, Konstantinos From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Alexandrov, Anne W
Autor Alexandrov, Anne W From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Alexandrov, Andrei V
Autor Alexandrov, Andrei V From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.)
Tsivgoulis, Georgios
Autor Tsivgoulis, Georgios From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.). tsivgoulisgiorg@yahoo.gr

Hypertension (Dallas, Tex.. 2017 Jan ; 69 (1) : 171-179. [epub] 20161031

Hypertension
ISSN 1524-4563 | 0194-911X
Zdroj

Jazyk angličtina Země Spojené státy americké Médium print-electronic

Typ dokumentu časopisecké články, metaanalýza, přehledy, systematický přehled

Perzistentní odkaz https://www.medvik.cz/link/pmid27802419

PubMed 27802419
DOI 10.1161/hypertensionaha.116.08485
PII: HYPERTENSIONAHA.116.08485
Knihovny.cz E-zdroje

Klíčová slova
antihypertensive agents, blood pressure, meta-analysis, regression analysis, stroke,
MeSH
cévní mozková příhoda etiologie prevence a kontrola MeSH
chování snižující riziko * MeSH
hypertenze komplikace patofyziologie terapie MeSH
hypoglykemika terapeutické užití MeSH
krevní tlak fyziologie MeSH
lidé MeSH
randomizované kontrolované studie jako téma * MeSH
sekundární prevence metody MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH
metaanalýza MeSH
přehledy MeSH
systematický přehled MeSH
Názvy látek
hypoglykemika MeSH

Current recommendations do not specifically address the optimal blood pressure (BP) reduction for secondary stroke prevention in patients with previous cerebrovascular events. We conducted a systematic review and metaregression analysis on the association of BP reduction with recurrent stroke and cardiovascular events using data from randomized controlled clinical trials of secondary stroke prevention. For all reported events during each eligible study period, we calculated the corresponding risk ratios to express the comparison of event occurrence risk between patients randomized to antihypertensive treatment and those randomized to placebo. On the basis of the reported BP values, we performed univariate metaregression analyses according to the achieved BP values under the random-effects model (Method of Moments) for those adverse events reported in ≥10 total subgroups of included randomized controlled clinical trials. In pairwise meta-analyses, antihypertensive treatment lowered the risk for recurrent stroke (risk ratio, 0.73; 95% confidence interval, 0.62-0.87; P<0.001), disabling or fatal stroke (risk ratio, 0.71; 95% confidence interval, 0.59-0.85; P<0.001), and cardiovascular death (risk ratio, 0.85; 95% confidence interval, 0.75-0.96; P=0.01). In metaregression analyses, systolic BP reduction was linearly related to the lower risk of recurrent stroke (P=0.049), myocardial infarction (P=0.024), death from any cause (P=0.001), and cardiovascular death (P<0.001). Similarly, diastolic BP reduction was linearly related to a lower risk of recurrent stroke (P=0.026) and all-cause mortality (P=0.009). Funnel plot inspection and Egger statistical test revealed no evidence of publication bias. The extent of BP reduction is linearly associated with the magnitude of risk reduction in recurrent cerebrovascular and cardiovascular events. Strict and aggressive BP control seems to be essential for effective secondary stroke prevention.

From the 2nd Department of Neurology

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Action Plan for Stroke in Europe 2018-2030

European stroke journal. 2018 Dec ; 3 (4) : 309-336. [epub] 20181029

Eur Stroke J
ISSN 2396-9881 | 2396-9873
Zdroj

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v BMČ

Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials

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