ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2019
Effect of Postural Hypotension on Recurrent Stroke: Secondary Prevention of Small Subcortical Strokes (SPS3) Study.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 20 citations in OpenAlex.
- Very early tilt-table verticalization unmasks impaired cerebral autoregulation within 24 h after endovascular thrombectomy: a transcranial Doppler study.Frontiers in neurology · 2025Article
- Prevalence and Outcomes of Orthostatic Hypotension in Hemorrhagic Stroke Patients During Hospitalization.Neurology international · 2024Article
- Elevated Fibrinogen-to-Albumin Ratio Correlates with Incident Stroke in Cerebral Small Vessel Disease.Journal of inflammation research · 2024Article
- Orthostatic hypotension in stroke/TIA patients: Association with new events and the effect of the NAILED intervention.PloS one · 2024Article
- Risk factors for stroke recurrence in young patients with first-ever ischemic stroke: A meta-analysis.World journal of clinical cases · 2023Article
- Role of Orthostatic Hypotension in the Development of Dementia in People With and Without Cardiovascular Disease.Hypertension (Dallas, Tex. : 1979) · 2023Article
- Diagnosis and treatment of orthostatic hypotension.The Lancet. Neurology · 2022Review
- Prevalence of orthostatic hypertension and its association with cerebrovascular diagnoses in patients with suspected TIA and minor stroke.BMC cardiovascular disorders · 2022Article
- Genetic predisposition to neurodegenerative diseases and risk of stroke: A Mendelian randomization study.Frontiers in neuroscience · 2022Article
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundOrthostatic hypotension (OH) has been independently associated with increased risk of stroke and other cardiovascular events. We sought to investigate the relationship between OH at follow-up and recurrent stroke risk in SPS3 (Secondary Prevention of Small Subcortical Strokes) trial patient cohort. This is a retrospective cohort analysis.
methodsWe included all SPS3 trial participants with blood pressure measurements in both sitting and standing position per protocol at baseline, with at least 1 follow-up visit to establish the relationship between OH at follow-up and recurrent stroke risk (primary outcome). Secondary outcomes included major vascular events, myocardial infarction, all-cause mortality, and, ischemic and hemorrhagic stroke subtypes. Participants were classified as having OH at baseline and at each follow-up visit based on a systolic BP decline ≥20 mm Hg or a diastolic BP decline ≥10 mm Hg on position change from sitting to standing. We used Cox proportional hazards regression modeling to compare the risk of outcomes among those with and without OH.
resultsA total of 2275 patients were included with a mean follow up time 3.2 years (standard deviation = 1.6 years). 39% (881/2275) had OH at some point during their follow-up. Of these, 41% (366/881) had orthostatic symptoms accompanying the BP drop. In a fully adjusted model, those with OH had a 1.8 times higher risk of recurrent stroke than those without OH (95% confidence interval: 1.1-3.0). The risk of ischemic stroke, major vascular events, and all-cause mortality was similarly elevated among the OH group.
conclusionOH was associated with increased recurrent stroke risk, vascular events, and all-cause death in this large cohort of lacunar stroke patients. Whether minimizing OH in the management of poststroke hypertension in patients with lacunar stroke reduces recurrent stroke risk deserves further study.
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