title: Association of hypertension with stroke recurrence depends on ischemic stroke subtype.
abstract: OBJECTIVE
  The association between hypertension (HTN) and stroke recurrence is unclear, but may be influenced by different subtypes of stroke. This study aims to explore whether HTN contributes to the recurrence of certain subtypes of ischemic stroke (IS).
  
  
  METHODS
  Data from the China National Stroke Registry was examined and 1-year follow-up data for stroke recurrence was analyzed. Trial of Org 10172 in Acute Stroke Treatment criteria was used to classify the subtypes of all IS. HTN was defined when resting blood pressure was ≥ 140/90 mm Hg on repeated measurements during hospitalization or a patient had been on antihypertensive medication. Recurrent stroke was defined as a new neurological deficit compatible to IS or intracerebral hemorrhage. The association between HTN and stroke recurrence in patients with different IS subtypes was analyzed by using univariable and multivariable logistic regression models.
  
  
  RESULTS
  Of 11 560 patients with IS, 8409 (72.7%) had HTN and 2050 (17.7%) experienced a recurrent stroke within 1 year. Patients with HTN had an insignificantly higher stroke recurrence rate than those without (18.0% versus 17.0%; P=0.21). After stratification by Trial of Org 10172 in Acute Stroke Treatment subtypes, multivariable analysis revealed a significant association between HTN and stroke recurrence in small-artery occlusion subtype (odds ratio, 1.52; 95% confidence interval, 1.03-2.31), but not in the other subtypes (large-artery atherosclerosis: odds ratio, 0.99; 95% confidence interval, 0.81-1.21; cardioembolic: odds ratio, 1.14; 95% confidence interval, 0.75-1.73; other: odds ratio, 0.88; 95% confidence interval, 0.71-1.09).
  
  
  CONCLUSIONS
  Our results showed that HTN is specifically related to the recurrent strokes in patients with small-vessel diseases, not other subtypes of IS.
authors: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantanxili, Dongcheng District, Beijing, China.
authors: Yilong
authors: Y
authors: Wang
authors: Jie
authors: J
authors: Xu
authors: Xingquan
authors: X
authors: Zhao
authors: David
authors: D
authors: Wang
authors: Chunxue
authors: C
authors: Wang
authors: Liping
authors: L
authors: Liu
authors: Anxin
authors: A
authors: Wang
authors: Xia
authors: X
authors: Meng
authors: Hao
authors: H
authors: Li
authors: Yongjun
authors: Y
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications; D002545:Brain Ischemia / Q000145:classification / Q000209:etiology*; D002681:China; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000145:classification / Q000209:etiology*