CS 一级高血压卒中预防.pdf

ORIGINAL RESEARCH
Impact of Achieved Blood Pressure on First Stroke in plicated
Grade 1 Hypertension
Xianhui Qin, MD, PhD;* Youbao Li, MD;* Ningling Sun, MD; Mingli He, MD; Genfu Tang, MD; Delu Yin, MD; JiGuang Wang, MD; Min Liang, MD;
Binyan Wang, MD; Yong Huo, MD; Xin Xu, MD; Xiping Xu, MD, PhD; Fan Fan Hou, MD, PhD
Background-—We aimed to test the impact of achieved blood pressure (BP) on first stroke among patients with grade 1
hypertension and without cardiovascular diseases in the China Stroke Primary Prevention Trial.
Methods and Results-—A total of 3187 patients with plicated grade 1 hypertension were included. The risk of es
was assessed according to: (1) the proportion of visits in which BP was reduced to <140/90 mm Hg, and (2) the time-averaged
systolic BP (SBP) or diastolic BP levels during the study treatment period. The median antihypertensive treatment duration was
years. Only % of the participants discontinued the treatments because of adverse reaction. Overall, the risk of stroke
decreased with the increase of the proportion of study visits with BP <140/90 mm Hg (for per 5% increase; hazard ratio, [95%
–≥≥
Downloaded from CI, ]). Consistently, compared with patients with time-averaged SBP 140 or diastolic BP 90 mm Hg, the risk of stroke
was lower in patients with time-averaged SBP of 120 to <140 mm Hg (% versus %; hazard ratio, [95% CI, –]) or
diastolic BP <90 mm Hg (% versus %; hazard ratio, [95% CI, –]). The beneficial results were consistent across
age (<60 versus ≥60 years), sex, baseline SBP (<150 versus 150 to <160 mm Hg), study treatment groups (enalapril or enalapril-
folic acid), and hypertension subtypes (isolated systolic hypertension or systolic-diastolic hypertension). However, a time-averaged
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http://jaha./ SBP 120 mm Hg (versus 120 140 mm Hg) was associated with an increased risk for stroke. Similar results were observed for
composite car