Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Patients With Acute Ischemic Stroke The CATIS Randomized Clinical Trial FREE ONLINE FIRST Jiang He, MD, PhD1,2,3,4; Yonghong Zhang, MD, PhD1,2; Tan Xu, MD, PhD1; Qi Zhao, MD, PhD2; Dali Wang, MD5; Chung-Shiuan Chen, MS2; Weijun Tong, MD1; Changjie Liu, MD6; Tian Xu, MD1; Zhong Ju, MD7; Yanbo Peng, MD5; Hao Peng, MD1; Qunwei Li, MD8; Deqin Geng, MD9; Jintao Zhang, MD10; Dong Li, MD11; Fengshan Zhang, MD12; Libing Guo, MD13; Yingxian Sun, MD14; Xuemei Wang, MD15; Yong Cui, MD16; Yongqiu Li, MD 17; Dihui Ma, MD18; Guang Yang, MD19; Yanjun Gao, MD20; Xiaodong Yuan, MD21; Lydia A. Bazzano, MD, PhD2,3,4; Jing Chen, MD, MS2,3,4; for the CATIS Investigators [+] Author Affiliations JAMA. Published online November 17, 2013. doi:10.1001/jama.2013.282543 Text Size: A A A . Article Figures Tables References . ABSTRACT. ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES .. Importance Although the benefit of reducing blood pressure for primary and secondary prevention of stroke has been established, the effect of antihypertensive treatment in patients with acute ischemic stroke is uncertain. Objective To evaluate whether immediate blood pressure reduction in patients with acute ischemic stroke would reduce death and major disability at 14 days or hospital discharge. Design, Setting, and Participants The China Antihypertensive Trial in Acute Ischemic Stroke, a single-blind, blinded end-points randomized clinical trial, conducted among 4071 patients with nonthrombolysed ischemic stroke within 48 hours of onset and elevated systolic blood pressure. Patients were recruited from 26 hospitals across China between August 2009 and May 2013. Interventions Patients (n=2038) were randomly assigned to receive antihypertensive treatment (aimed at lowering systolic blood pressure by 10% to 25% within the first 24 hours after randomization, achieving blood pressure less than 140/90 mm Hg within 7 days, and maintaining this level during hospitalization) or to discontinue all antihypertensive medications (control) during hospitalization (n=2033). Main Outcomes and Measures Primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 14 days or hospital discharge. Results Mean systolic blood pressure was reduced from 166.7 mm Hg to 144.7 mm Hg (−12.7%) within 24 hours in the antihypertensive treatment group and from 165.6 mm Hg to 152.9 mm Hg (−7.2%) in the control group within 24 hours after randomization (difference, −5.5% [95% CI, −4.9 to −6.1%]; absolute difference, −9.1 mm Hg [95% CI, −10.2 to −8.1]; P
Posted on: Mon, 18 Nov 2013 20:40:49 +0000
Trending Topics
Recently Viewed Topics
© 2015