Realizing Benefits From More Intensive Blood Pressure Control for Preventing Recurrent Stroke

Blood pressure (BP) targets below 140/90 mm Hg in high-risk patients, such as those who have had a stroke, remain a controversial topic. A pivotal meta-analysis of 61 prospective observational studies involving 1 million adults without previous cardiovascular (CV) disease showed a linear association between usual BP levels and deaths from ischemic heart disease and stroke, down to BP levels as low as 115/75 mm Hg. These data prompted the “lower the better” hypothesis and challenged the long-standing argument of a J-curve or U-curve association of BP levels in such patients. Before the pivotal Systolic Blood Pressure Intervention Trial (SPRINT), there had been few trials of more intensive long-term BP lowering, and they have gene rally failed to show a clear reduction in the risk of serious CV events, with the exception of stroke, for a systolic BP less than 120 mm Hg compared with less than 140 mm Hg. Although SPRINT provides some reassurance that the benefits of more intensive BP lowering outweigh the justifiable concerns over harms, such as hypotension and renal impairment, especially in elderly individuals, the study has been criticized about the generalizability of the results to patients with a history of stroke, who were purposefully excluded, and about the use of unattended automated BP measurements to titrate therapy in a highly intensive monitoring schedule.
Source: JAMA Neurology - Category: Neurology Source Type: research

Related Links:

Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Publication date: Available online 3 December 2019Source: The LancetAuthor(s): Fabian J Brunner, Christoph Waldeyer, Francisco Ojeda, Veikko Salomaa, Frank Kee, Susana Sans, Barbara Thorand, Simona Giampaoli, Paolo Brambilla, Hugh Tunstall-Pedoe, Marie Moitry, Licia Iacoviello, Giovanni Veronesi, Guido Grassi, Ellisiv B Mathiesen, Stefan Söderberg, Allan Linneberg, Hermann Brenner, Philippe Amouyel, Jean FerrièresSummaryBackgroundThe relevance of blood lipid concentrations to long-term incidence of cardiovascular disease and the relevance of lipid-lowering therapy for cardiovascular disease outcomes is unclear....
Source: The Lancet - Category: General Medicine Source Type: research
In this study, the soft computing method known as fuzzy cognitive mapping was proposed for diagnosis of the risk of ischemic stroke. Non-linear Hebbian learning method was used for fuzzy cognitive maps training. In the proposed method, the risk rate for each person was determined based on the opinions of the neurologists. The accuracy of the proposed model was tested using 10-fold cross-validation, for 110 real cases, and the results were compared with those of support vector machine and K-nearest neighbours. The proposed system showed a superior performance with a total accuracy of (93.6 ± 4.5)%. The ...
Source: IET Systems Biology - Category: Biology Source Type: research
Conclusion: High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement.RESUMO Introdu ção: As proporções de causas de morte mal definidas (CMD) foram elevadas no Brasil em 2000. Objetivo: Analisar causas específicas para óbitos originalmente como CMD no Sistema de Informação sobre Mortal...
Source: Revista Brasileira de Epidemiologia - Category: Epidemiology Source Type: research
ConclusionDuring long-term follow-up, one out of six patients experienced symptomatic arrhythmias after AVNRT ablation, associated with an increase of serious adverse events. A subset of patients required medical or interventional antiarrhythmic therapy, possibly attributable to the co-existence of other arrhythmias. Screening for arrhythmic and cardiac co-morbidity before and after ablation may support comprehensive therapy planning and outcome.
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
CONCLUSION: During long-term follow-up, one out of six patients experienced symptomatic arrhythmias after AVNRT ablation, associated with an increase of serious adverse events. A subset of patients required medical or interventional antiarrhythmic therapy, possibly attributable to the co-existence of other arrhythmias. Screening for arrhythmic and cardiac co-morbidity before and after ablation may support comprehensive therapy planning and outcome. PMID: 31784903 [PubMed - as supplied by publisher]
Source: Clin Med Res - Category: Research Authors: Tags: Clin Res Cardiol Source Type: research
This study explored the proportion of NAFLD cases and increased liver fibrosis (LF), and the association between LF and either chronic kidney disease (CKD) or cardiovascular complications in T2DM patients. METHODS: - The study included 137 patients with non-insulin-treated T2DM and no known liver disease consecutively attending our diabetes outpatients service who underwent liver ultrasonography and liver stiffness measurement (LSM) using vibration-controlled transient elastography (FibroScan®). RESULTS: - The proportion of patients with hepatic steatosis on ultrasonography was 73.7%, and the proportion with ...
Source: Diabetes and Metabolism - Category: Endocrinology Authors: Tags: Diabetes Metab Source Type: research
ConclusionsWork-unit organizational change may be associated with excess risk of incident CVD among the employees relative to stable workplaces.
Source: International Archives of Occupational and Environmental Health - Category: Occupational Health Source Type: research
This study aimed to assess the associations of pregnancy loss and risk of hypertension, type 2 diabetes (T2D), and hypercholesterolemia.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mother, Fetus, Neonate Source Type: research
Abstract In addition to the complications of leprosy, people affected by leprosy (PALs) can suffer from chronic diseases. We evaluated the recent pattern of deaths among Korean PALs and compared it with that in the general population. We analyzed the death certificate data of 1,359 PALs from 2010 through 2013. The all-cause and cause-specific standardized mortality ratio (SMR) and standardized mortality with 95% CI were calculated. Malignancy had the highest standardized mortality, with 130.9 deaths per 100,000 persons, followed by cardiovascular diseases (CVDs; 85.5 deaths) and respiratory diseases (38.2 deaths)....
Source: The American Journal of Tropical Medicine and Hygiene - Category: Tropical Medicine Authors: Tags: Am J Trop Med Hyg Source Type: research
More News: Brain | Cardiology | Cardiovascular | Genetics | Heart | Heart Disease | Ischemic Stroke | Neurology | Stroke | Study