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Should Blood Pressure Targets After Lacunar Stroke Vary by Body Size? The SPS3 Trial
Journal article   Open access   Peer reviewed

Should Blood Pressure Targets After Lacunar Stroke Vary by Body Size? The SPS3 Trial

Thalia S Field, Leslie A McClure, Carole L White, Pablo E Pergola, Robert G Hart, Oscar R Benavente, Michael D Hill and SPS3 Investigators
American journal of hypertension, v 28(6), pp 756-764
Jun 2015
DOI: https://doi.org/10.1093/ajh/hpu228
PMID: 25452300
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1093/ajh/hpu228View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Aged Antihypertensive Agents - therapeutic use Blood Pressure Determination - methods Body Mass Index Body Size Body Surface Area Drug Therapy, Combination Female Humans Hypertension - complications Hypertension - diagnosis Hypertension - drug therapy Male Middle Aged Prognosis Proportional Hazards Models Recurrence Secondary Prevention Statistics as Topic Stroke, Lacunar - diagnosis Stroke, Lacunar - etiology Stroke, Lacunar - prevention & control
It is unknown whether the physiological impact of a given blood pressure (BP) varies by body size. We explored interactions between higher vs. lower systolic BP (SBP) targets and anthropometric measures (body mass index (BMI), body surface area (BSA), height, weight) and recurrent stroke and death in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial. Patients with recent magnetic resonance imaging-proven lacunar infarcts were randomized to 2 BP targets (130-149 mm Hg vs. <130) in a prospective, open-label, blinded end-point design. Time to outcome was evaluated with Cox proportional hazard models and compared between targets. We examined multiplicative interactions between each anthropometric measure and target and mean difference in achieved BP 1 year after randomization between BP groups by quartile. We also computed rates of recurrent stroke and death by quartiles of anthropometrics. Three thousand and twenty patients were followed over a mean of 3.7 (SD 2.0) years. Mean age was 63; 63% were male. Mean height was 167 (SD 11) cm, weight 81 (18) kg, BMI 29 (5.9) kg/m(2), and BSA 1.9 (0.25) m(2). Achieved BP at 1 year was comparable between quartiles for each anthropometric measurement. We found no consistent interactions between BP target and anthropometrics for either outcome, nor were there any significant associations between hazard of stroke or death when assessed by BMI, BSA, height, or weight. We found no interactions between BP target groups and quartiles of anthropometrics for rates of stroke and death in SPS3. There is no evidence at this time supporting body size-based modifications to current BP targets for secondary prevention after lacunar stroke. Trial Number NCT00059306.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Peripheral Vascular Disease
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