COMMENTARY

Aggressive Blood Pressure Lowering After Stroke Yields Mixed Outcomes

Tejas P. Desai, MD

Disclosures

May 09, 2016

Effect of Intensive Versus Usual Blood Pressure Control on Kidney Function Among Individuals With Prior Lacunar Stroke A Post Hoc Analysis of the Secondary Prevention of Small Subcortical Strokes (SPS3) Randomized Trial

Peralta CA, McClure LA, Scherzer R, et al
Circulation. 2016;133:584-591

Aggressive Blood Pressure Lowering After Stroke Yields Mixed Outcomes

The optimal blood pressure range has been debated for years. For a long time, one couldn't go wrong in recommending the lowest tolerable blood pressure for one's patients. And while recent data from SPRINT[1] have suggested that aggressive lowering of blood pressure results in fewer cardiovascular events and deaths, not all of the outcomes are positive. SPRINT surprised many by suggesting that aggressive blood pressure control led to a greater decline in kidney function in previously healthy patients. To further examine this finding, the authors of the current investigation reanalyzed the Secondary Prevention of Small Subcortical Strokes (SPS3) study. They wanted to know whether the surprising deleterious effect of aggressive blood pressure control on kidney function is seen in patients with a history of stroke.

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