title: Blood pressure after recent stroke: baseline findings from the secondary prevention of small subcortical strokes trial.
abstract: BACKGROUND
  Hypertension is the most powerful risk factor for stroke. The aim of this study was to characterize baseline blood pressure in participants in the Secondary Prevention of Small Subcortical Strokes trial.
  
  
  METHODS
  For this cross-sectional analysis, participants were categorized by baseline systolic blood pressure (SBP) < 120, 120-139, 140-159, 160-179, and ≥ 180 mm Hg and compared on demographic and clinical characteristics. Predictors of SBP < 140 mm Hg were examined.
  
  
  RESULTS
  Mean SBP was 143±19 mm Hg while receiving an average of 1.7 antihypertensive medications; SBP ≥ 140 mm Hg for 53% and ≥ 160 mm Hg for 18% of the 3,020 participants. Higher SBP was associated with a history of hypertension and hypertension for longer duration (both P < 0.0001). Higher SBPs were associated with more extensive white matter disease on magnetic resonance imaging (P < 0.0001). There were significant differences in entry-level SBP when participants were categorized by race and region (both P < 0.0001). Black participants were more likely to have SBP ≥ 140 mm Hg. Multivariable logistic regression showed an independent effect for region with those from Canada more likely (odds ratio = 1.7; 95% confidence interval, 1.29, 2.32) to have SBP < 140 mm Hg compared with participants from United States.
  
  
  CONCLUSIONS
  In this cohort with symptomatic lacunar stroke, more than half had uncontrolled hypertension at approximately 2.5 months after stroke. Regional, racial, and clinical differences should be considered to improve control and prevent recurrent stroke.
authors.affiliation: School of Nursing, University of Texas Health Sciences Center at San Antonio, San Antonio, TX.
authors.forename: Carole L
authors.initials: CL
authors.lastname: White
authors.forename: Pablo E
authors.initials: PE
authors.lastname: Pergola
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Szychowski
authors.forename: Robert
authors.initials: R
authors.lastname: Talbert
authors.forename: Amin
authors.initials: A
authors.lastname: Cervantes-Arriaga
authors.forename: Heather D
authors.initials: HD
authors.lastname: Clark
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Del Brutto
authors.forename: Ivan Esteban
authors.initials: IE
authors.lastname: Godoy
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Antoni
authors.initials: A
authors.lastname: Pelegrí
authors.forename: Craig R
authors.initials: CR
authors.lastname: Sussman
authors.forename: Addison A
authors.initials: AA
authors.lastname: Taylor
authors.forename: José
authors.initials: J
authors.lastname: Valdivia
authors.forename: Dave C
authors.initials: DC
authors.lastname: Anderson
authors.forename: Robin
authors.initials: R
authors.lastname: Conwit
authors.forename: Oscar R
authors.initials: OR
authors.lastname: Benavente
mesh_terms: D000328:Adult; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D044383:Black People; D001794:Blood Pressure / Q000502:physiology; D002170:Canada; D003430:Cross-Sectional Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007843:Latin America; D055502:Secondary Prevention; D020521:Stroke / Q000517:prevention & control; D014481:United States; D001741:Black or African American
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
keywords: blood pressure; blood pressure control; ethnicity; hypertension; ischemic stroke; lacunar stroke; risk factors; stroke prevention; white matter disease.