SynthesisEuropean journal of medical research2025
Antihypertensive strategies for the prevention of secondary stroke: a systematic review and meta-analysis.
Synthesis in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Early Versus Delayed Antihypertensive Therapy in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Annals of Indian Academy of Neurology · 2026Article
- [Developmental trajectories of medication adherence and predictors of latent classes in patients with ischemic stroke].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026Article
- Headache After Stroke: An Update for the Clinician.Current neurology and neuroscience reports · 2025Review
- Elevated TyG-BMI significantly increases the 1-year stroke recurrence risk in patients with acute ischemic stroke and hypertension.Frontiers in endocrinology · 2025Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStroke is an important contributor to disability and death globally. Hypertension is a main risk factor for recurrent stroke in patients with ischemic and hemorrhagic stroke or transient ischemic attack. Higher systolic blood pressure, diastolic blood pressure, pulse pressure and mean arterial pressure at admission are independently associated with the risk of stroke recurrence. Therefore, lowering blood pressure is recommended by guidelines to prevent the recurrence of stroke.
methodsA systematic search of PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted through January 12, 2024. The search identified randomized controlled trials (RCTs) comparing antihypertensive drugs with control measures (placebo or no treatment) or standard blood pressure control (SBPC) with intensive blood pressure control (IBPC) for recurrent stroke prevention. Primary outcomes included overall and subtype stroke recurrence rates, fatal and non-fatal strokes, cardiovascular deaths, and myocardial infarctions (MIs). Secondary outcomes comprised non-fatal MIs and all-cause mortality. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random or fixed-effect models in Stata 15.0.
resultsThe analysis included 19 RCTs encompassing 72,048 patients. Twelve studies (n = 53,971) evaluated antihypertensive drugs against placebo or no treatment, while seven studies (n = 18,077) compared SBPC with IBPC. Antihypertensive therapy demonstrated significant risk reductions compared to placebo or no treatment for recurrent stroke (RR = 0.86, 95% CI: 0.75-0.97), cardiovascular deaths (RR = 0.92, 95% CI: 0.87-0.97), and MIs (RR = 0.87, 95% CI: 0.79-0.96). IBPC showed superior outcomes compared to SBPC, with significant reductions in recurrent stroke (RR = 0.87, 95% CI: 0.77-0.98), cardiovascular deaths (RR = 0.75, 95% CI: 0.61-0.91), and all-cause mortality (RR = 0.85, 95% CI: 0.73-0.95).
conclusionIn stroke patients, antihypertensive therapy demonstrates significant protective effects against stroke recurrence, cardiovascular deaths, and MIs compared to placebo or no treatment. Additionally, IBPC provides enhanced protection against stroke recurrence, cardiovascular deaths, and all-cause mortality compared to SBPC.
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