SynthesisPloS one2014
Effects of early blood pressure lowering on early and long-term outcomes after acute stroke: an updated meta-analysis.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Blood Pressure Reduction Time Windows in Stroke: A Systematic Review and Network Meta-Analysis.Brain and behavior · 2026Pooled it
- The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019Guideline
- Pooled it
- Review
- Cerebral hemodynamic effects of early blood pressure lowering after TIA and stroke in patients with carotid stenosis.International journal of stroke : official journal of the International Stroke Society · 2022Article
- Predictors of stroke favorable functional outcome in Guinea, results from the Conakry stroke registry.Scientific reports · 2022Article
- Evaluation of Systolic Blood Pressure, Use of Aspirin and Clopidogrel, and Stroke Recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial.JAMA network open · 2021Article
- Cerebral Autoregulation in Ischemic Stroke: From Pathophysiology to Clinical Concepts.Brain sciences · 2021Review
- Article
- [Anesthesiological management in endovascular stroke treatment].Der Anaesthesist · 2019Review
- Antihypertensive therapy in acute ischemic stroke: where do we stand?Journal of human hypertension · 2018Review
- Efficacy of Antihypertensive Therapy in the Acute Stage of Cerebral Infarction - A Prospective, Randomized Control Trial.Acta Cardiologica Sinica · 2018Article
- Blood Pressure Goals in Acute Stroke-How Low Do You Go?Current hypertension reports · 2018Review
- Determinants of the impact of blood pressure variability on neurological outcome after acute ischaemic stroke.Stroke and vascular neurology · 2017Article
- Therapies to Reduce Blood Pressure Acutely.Current hypertension reports · 2016Review
- Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke.Stroke research and treatment · 2016Article
- Timing of blood pressure lowering in acute ischemic stroke.Current atherosclerosis reports · 2015Review
- High Blood Pressure Increases the Risk of Poor Outcome at Discharge and 12-month Follow-up in Patients with Symptomatic Intracranial Large Artery Stenosis and Occlusions: Subgroup analysis of the CICAS Study.CNS neuroscience & therapeutics · 2015Article
- Increased blood pressure variability after acute ischemic stroke increases the risk of death: A secondary analysis of the Virtual International Stroke Trial Archive.JRSM cardiovascular diseaseArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypertension is common after acute stroke onset. Previous studies showed controversial effects of early blood pressure (BP) lowering on stroke outcomes. The aim of this study is to assess the effects of early BP lowering on early and long-term outcomes after acute stroke.
methodsA meta-analysis was conducted with prospective randomized controlled trials assessing the effects of early BP lowering on early and long-term outcomes after acute stroke compared with placebo. Literature searching was performed in the databases from inception to December 2013. New evidence from recent trials were included. Outcomes were analyzed as early (within 30 days) and long-term (from 3 to 12 months) endpoints using summary estimates of relative risks (RR) and their 95% confidence intervals (CI) with the fixed-effect model or random-effect model.
resultsSeventeen trials providing data from 13236 patients were included. Pooled results showed that early BP lowering after acute stroke onset was associated with more death within 30 days compared with placebo (RR: 1.34 and 95% CI: 1.02, 1.74, p = 0.03). However the results showed that early BP lowering had no evident effect on early neurological deterioration, early death within 7 days, long-term death, early and long-term dependency, early and long-term combination of death or dependency, long-term stroke recurrence, long-term myocardial infarction and long-term CVE.
conclusionsThe new results lend no support to early BP lowering after acute stroke. Early BP lowering may increase death within 30 days after acute stroke.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.