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Long-term systolic blood pressure and cardiovascular risks among patients with ischemic stroke: a register-based

Chunbao Mo1,2, Xia Li1,2, Shuang Wang3

  • 1School of Public Health and Emergency Management, School of Medicine, Southern University of Science and Technology, Shenzhen, China.

Journal of Global Health
|November 7, 2025
PubMed

Insights

Maintaining normal or high-normal systolic blood pressure (SBP) after ischemic stroke (IS) is linked to reduced risks of recurrent stroke and major adverse cardiovascular events (MACE). Optimal SBP levels may offer greater health benefits, particularly for patients aged 45-70.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Long-term systolic blood pressure (SBP) impact on cardiovascular outcomes post-ischemic stroke (IS) is understudied.
  • Existing research primarily focuses on blood pressure fluctuations, not sustained levels.

Purpose of the Study:

  • To investigate the association between long-term SBP levels and risks of recurrent stroke and major adverse cardiovascular events (MACE) in IS patients.
  • To identify optimal SBP trajectories for improved patient prognosis and quantify potential health benefits.

Main Methods:

  • Retrospective cohort study of 11,357 IS patients in Shenzhen, China (2017-2023).
  • Group-based trajectory models (GBTM) identified one-year SBP patterns post-discharge.
  • Propensity score-overlap weighted Cox regression analyzed associations between SBP levels and MACE over 36-month follow-up.

Main Results:

  • Three SBP patterns identified: normal (n=2120), high-normal (n=7949), and uncontrolled (n=1288).
  • Normal and high-normal SBP were associated with significantly lower risks of recurrent stroke or MACE (HRs 0.68-0.89) compared to uncontrolled SBP.
  • Patients aged 45-70 with normal/high-normal SBP showed potential for greater event-free survival benefits.

Conclusions:

  • Sustained normal or high-normal SBP levels one year post-discharge are associated with reduced cardiovascular event risk in IS patients.
  • Achieving optimal SBP may lead to significant long-term health benefits, especially in younger to middle-aged IS survivors.
Abstract

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