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Achieved blood pressures in the secondary prevention of small subcortical strokes (SPS3) study: challenges and

Pablo E Pergola1, Carole L White2, Jeff M Szychowski3

  • 1Department of Medicine, University of Texas Health Sciences Center at San Antonio and Renal Associates PA, San Antonio, Texas;

American Journal of Hypertension
|March 11, 2014
PubMed

Insights

Lowering blood pressure (BP) to <130mm Hg after stroke is achievable and safe. Protocol-driven care effectively reduced BP in diverse patient groups, supporting stroke prevention strategies.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Clinical Trials

Background:

  • Blood pressure management post-stroke presents significant challenges, even within clinical trials.
  • The Secondary Prevention of Small Subcortical Strokes (SPS3) study investigated blood pressure (BP) protocols and achieved BP levels.

Purpose of the Study:

  • To describe the BP management protocol used in the SPS3 trial.
  • To analyze achieved BP levels in patients with recent symptomatic lacunar stroke.
  • To examine BP management across different racial/ethnic groups and baseline conditions.

Main Methods:

  • Patients were randomized to a lower systolic BP (SBP) target (<130mm Hg) or a higher target (130-149mm Hg).
  • SBP management was monitored throughout the trial.
  • Medication use and time to reach target BP were assessed.

Main Results:

  • Mean SBP decreased in both groups, reaching 126.7mm Hg (lower target) and 137.4mm Hg (higher target).
  • Antihypertensive medication use increased from baseline to study end.
  • Black participants showed a higher proportion of SBP ≥150mm Hg compared to White and Hispanic participants.

Conclusions:

  • Safely achieving SBP <130mm Hg is feasible in diverse patient populations and settings.
  • Protocol-driven care is effective in lowering BP and can help reduce the stroke burden.
  • Findings support the implementation of standardized BP management protocols for stroke prevention.
Abstract

Keywords:
achieved blood pressuresblood pressureblood pressure managementhypertensionischemic strokelacunar strokestroke prevention.

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