title: Optimal Blood Pressure in Patients after Stroke in Rural Areas of China.
abstract: BACKGROUND
  The purpose of this study was to investigate the impact of different blood pressure (BP) categories on risk of developing cardiovascular disease (CVD) events and mortality, and to evaluate the optimal range of BP in patients after stroke in rural areas of China.
  
  
  METHODS
  We performed a post hoc analysis of 1058 patients with a history of stroke or transient ischemic attack from the Northeast China Rural Cardiovascular Health Study. The average follow-up systolic blood pressure (SBP) and diastolic blood pressure (DBP) were categorized into 10-mm Hg increments. The primary outcome was a composite of death due to any cause, nonfatal coronary heart disease, and nonfatal stroke. The secondary outcomes were recurrent stroke, CVD events, CVD mortality, and all-cause mortality.
  
  
  RESULTS
  The relationship between BP (systolic and diastolic) followed a J- or U-shaped curve with primary and secondary outcomes, with increased event rates at low and high BP values, both unadjusted variables and after adjustment for baseline confounding variables. The event rates were lowest in the SBP of 110-119 and DBP of 80-89 mm Hg. Patients with a BP lower than 110/70 or 140/90 mm Hg or higher had a significantly increased risk of worse outcomes.
  
  
  CONCLUSIONS
  For stroke survivors, a J- or U-shaped curve association exists between BP and the risk of future CVD events and mortality, with the lowest event rates in the BP range of 110-119 systolic and 80-89 diastolic. SBPs of 110-139 and DBPs of 70-89 are the appropriate range for patients after stroke in rural areas of China.
authors.affiliation: Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai, China.
authors.forename: Miaomiao
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xiankai
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Liqiang
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, St. Mary Medical Center, Hobart, Indiana.
authors.forename: Thach
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Department of Cardiology, the First Hospital of China Medical University, Shenyang, Liaoning, China. Electronic address: yxsun@mail.cmu.edu.cn.
authors.forename: Yingxian
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai, China. Electronic address: mmz_1989@163.com.
authors.forename: Jue
authors.initials: J
authors.lastname: Li
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology*; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012424:Rural Population; D020521:Stroke / Q000503:physiopathology*
keywords: Blood pressure; prospective study; rural areas of China; stroke survivors; target range; worse outcomes