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Blood pressure management to prevent recurrent stroke: current evidence and perspectives

Gisele Sampaio Silva1,2, João Brainer Clares de Andrade3,4,5, Eduardo Bello Martins1

  • 1Hospital Israelita Albert Einstein, 755 Comendador Elias Jafet Street, room 408/409, Floor L4, Morumbi, São Paulo, SP, Postal Code 05653-000, Brazil.

NPJ Cardiovascular Health
|March 3, 2026
PubMed

Insights

High blood pressure significantly increases stroke risk. While effective blood pressure management is crucial for preventing recurrent strokes, research findings on intensive control strategies remain mixed, highlighting ongoing challenges.

Area of Science:

  • Neurology
  • Cardiology
  • Public Health

Background:

  • Hypertension is the primary risk factor for stroke, accounting for approximately 60% of all cases.
  • Effective blood pressure control is essential for preventing secondary ischemic strokes.
  • Existing research presents conflicting results regarding the efficacy of intensive blood pressure management strategies.

Purpose of the Study:

  • To synthesize current evidence on the role of blood pressure control in preventing recurrent ischemic strokes.
  • To evaluate the impact of intensive blood pressure control on cardiovascular events.
  • To explore the influence of technological advancements and persistent challenges in achieving equitable hypertension management.

Main Methods:

  • Review of key clinical trials including SPRINT, PROGRESS, STEP, and RESPECT.
  • Analysis of data on cardiovascular event reduction associated with different blood pressure control intensities.
  • Consideration of the role of artificial intelligence (AI) and wearable technology in hypertension management.

Main Results:

  • Intensive blood pressure control demonstrated a reduction in cardiovascular events in studies like SPRINT, PROGRESS, and STEP.
  • Some trials, such as RESPECT, did not show a significant difference in outcomes with intensive control.
  • Technological advancements offer potential for improved hypertension management.
  • Significant disparities in achieving equitable blood pressure control persist, particularly among minority populations.

Conclusions:

  • Effective blood pressure management is critical for secondary stroke prevention, but optimal strategies require further clarification due to mixed trial results.
  • While technology can aid in hypertension management, addressing health equity and disparities is paramount for widespread effective control.
  • Further research is needed to reconcile conflicting findings and ensure equitable access to effective stroke prevention strategies.

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