Reduction in blood pressure: Does the J curve still talk??

A ‘J-curve’ association between blood pressure (BP) and stroke has been previously reported, whereby highest and the lowest BPs were associated with increased risks of recurrent stroke among patients with recent ischaemic stroke.  Clearly, such a finding has management implications.  In an upcoming issue of JNNP, the PROGRESS Collaborative Group dismiss this myth.  Namely, large reductions of BP (> 20 mmHg) WERE NOT associated with an increased risk of any types of stroke, with the annual incidence hovering between 2-3%.

 

So I guess, the answer may well be to treat hypertension aggressively, but not to the point of dizziness.

 

Read more:  http://jnnp.bmj.com/content/early/2014/05/14/jnnp-2014-307856.full

 

http://jnnp.bmj.com/content/early/2014/05/14/jnnp-2014-307856/F1.large.jpg

 

Degree of blood pressure reduction and recurrent stroke: the PROGRESS trial

  1. Hisatomi Arima1,
  2. Craig Anderson1,
  3. Teruo Omae2,
  4. Mark Woodward1,
  5. Stephen MacMahon1,3,
  6. Giuseppe Mancia4,
  7. Marie-Germaine Bousser5,
  8. Christophe Tzourio6,7,
  9. Stephen Harrap8,
  10. Lisheng Liu9,
  11. Bruce Neal1,
  12. John Chalmers1,
  13. for the PROGRESS Collaborative Group

J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2014-307856

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