机构：[1]The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.[2]National Cerebral and Cardiovascular Center, Suita, Japan.[3]The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia George Centre of Healthcare Innovation, University of Oxford, Oxford, UK.[4]Università Milano-Bicocca, Ospedale San Gerardo, Milan, Italy.[5]The Department of Neurology, Hôpital Lariboisière, Paris, France.[6]INSERM U897, Bordeaux, France University of Bordeaux, Bordeaux, France.[7]Department of Physiology, University of Melbourne, Melbourne, Australia.[8]National Centre for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.
There is ongoing controversy regarding a 'J-curve' phenomenon such that low and high blood pressure (BP) levels are associated with increased risks of recurrent stroke. We aimed to determine whether large treatment-related BP reductions are associated with increased risks of recurrent stroke.
Data are from the PROGRESS trial, where 6105 patients with cerebrovascular disease were randomly assigned to either active treatment (perindopril ± indapamide) or placebo(s). There were no BP criteria for entry. BP was measured at every visit, and participant groups defined by reduction in systolic BP (SBP) from baseline were used for the analyses. Outcome was recurrent stroke.
During a mean follow-up of 3.9 years, 727 recurrent strokes were observed. There were clear associations between the magnitude of SBP reduction and the risk of recurrent stroke. After adjustment for cardiovascular risk factors and randomised treatment, annual incidence was 2.08%, 2.10%, 2.31% and 2.96% for participant groups defined by SBP reductions of ≥ 20, 10-19, 0-9 and <0 mm Hg, respectively (p=0.0006 for trend).
The present analysis provided no evidence of an increase in recurrent stroke associated with larger reductions in SBP produced by treatment among patients with cerebrovascular disease.
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出版当年[2013]版：
大类|2 区医学
小类|1 区外科2 区临床神经病学2 区精神病学
最新[2025]版：
大类|1 区医学
小类|1 区临床神经病学1 区精神病学1 区外科
第一作者：
第一作者机构：[1]The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
推荐引用方式(GB/T 7714)：
Arima Hisatomi,Anderson Craig,Omae Teruo,et al.Degree of blood pressure reduction and recurrent stroke: the PROGRESS trial.[J].JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY.2014,85(11):1284-5.doi:10.1136/jnnp-2014-307856.
APA：
Arima Hisatomi,Anderson Craig,Omae Teruo,Woodward Mark,MacMahon Stephen...&Chalmers John.(2014).Degree of blood pressure reduction and recurrent stroke: the PROGRESS trial..JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY,85,(11)
MLA：
Arima Hisatomi,et al."Degree of blood pressure reduction and recurrent stroke: the PROGRESS trial.".JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY 85..11(2014):1284-5
医学