Evidence map›Paper›PMID 30592437›Full record

ArticleAnnals of medicine2019

Use of antihypertensive medication after ischemic stroke in young adults and its association with long-term outcome.

Myrna M E van Dongen, Karoliina Aarnio, Nicolas Martinez-Majander, Jani Pirinen, Juha Sinisalo, Mika Lehto, Markku Kaste, Turgut Tatlisumak, Frank-Erik de Leeuw, Jukka Putaala

Open access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Article
  3. Cerebrovascular risk factors and their time-dependent effects on stroke survival in the EMMA cohort study.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2023
    Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 3 countries.

Myrna M E van Dongena Department of Neurology , Center for Neuroscience, Radboudumc, Donders Institute for Brain, Cognition and Behaviour , Nijmegen , the Netherlands.ORCID 0000-0003-4972-837X
Karoliina Aarniob Department of Neurology, Clinical Neurosciences , University of Helsinki , Helsinki , Finland.
Nicolas Martinez-Majanderb Department of Neurology, Clinical Neurosciences , University of Helsinki , Helsinki , Finland.
Jani Pirinenb Department of Neurology, Clinical Neurosciences , University of Helsinki , Helsinki , Finland.
Juha Sinisalod Department of Cardiology, Heart and Lung Center , Helsinki University Hospital , Helsinki , Finland.
Mika Lehtod Department of Cardiology, Heart and Lung Center , Helsinki University Hospital , Helsinki , Finland.
Markku Kasteb Department of Neurology, Clinical Neurosciences , University of Helsinki , Helsinki , Finland.
Turgut Tatlisumakb Department of Neurology, Clinical Neurosciences , University of Helsinki , Helsinki , Finland.
Frank-Erik de Leeuwa Department of Neurology , Center for Neuroscience, Radboudumc, Donders Institute for Brain, Cognition and Behaviour , Nijmegen , the Netherlands.
Jukka Putaalab Department of Neurology, Clinical Neurosciences , University of Helsinki , Helsinki , Finland.
University of Helsinki · FIHelsinki University Hospital · FIRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKnowledge on the use of secondary preventive medication in young adults is limited.

methodsWe included 936 first-ever ischemic stroke 30-day survivors aged 15-49, enrolled in the Helsinki Young Stroke Registry, 1994-2007. Follow-up data until 2012 came from Finnish Care Register, Statistics Finland, and Social Insurance Institution of Finland. Usage thresholds were defined as non-users, low (prescription coverage <30%), intermediate (30-80%) and high users (>80%). Adjusted Cox regression allowed assessing the association of usage with all-cause mortality and recurrent vascular events.

resultsOf our patients, 40.5% were non-users, 7.8% had low usage, 11.8% intermediate usage and 40.0% high usage. Median follow-up was 8.3 years. Compared to non-users, risk of mortality and recurrent stroke or TIA was lower for patients with low-intermediate (HR 0.40, 95% CI 0.22-0.65; HR 0.31, 95% CI 0.18-0.53) and high usage (HR 0.25, 95% CI 0.15-0.42; HR 0.30, 95% CI 0.19-0.46), after adjustment for confounders.

conclusionsUse of antihypertensives was suboptimal in one-third of patients in whom antihypertensives were initially prescribed. Users were at lower risk of mortality and recurrent stroke or TIA compared to non-users. Key Messages The use of antihypertensive medication is suboptimal in one-third of patients in whom antihypertensive medication was initially prescribed after ischemic stroke at young age. The risk of mortality and recurrent stroke or TIA is lower for users of antihypertensive medication after ischemic stroke at young age compared to non-users, after adjustment for relevant confounders including pre-existing hypertension and prior use of antihypertensive medication. Specific guidelines on antihypertensive medication use after ischemic stroke at young age are lacking. However, our results may motivate doctors and patients in gaining better usage of antihypertensive medication, since better usage was associated with more favorable outcome in this study.

Indexed as

AdultAntihypertensive AgentsBrain IschemiaFemaleFinlandFollow-Up StudiesHumansHypertensionIschemic Attack, TransientMaleMiddle AgedPredictive Value of TestsRecurrenceRisk FactorsSecondary PreventionStrokeAntihypertensive AgentsBrain ischemia/drug therapyfollow-up studieshypertensionrecurrenceriskstroke/drug therapyyoung adults

Identifiers

PMID30592437
PMCPMC7857461
OpenAlexW2907138962

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.