Early Versus Delayed Antihypertensive Treatment After Acute Ischemic Stroke by Hypertension History

作者：Xuewei Xie, Chongke Zhong, Xin Liu, Yuesong Pan, Aili Wang, Yufei Wei, Dacheng Liu, Tan Xu, Yong Jiang, Mengxing Wang, Jing Jing, Xia Meng, Katherine Obst, Chung-Shiuan Chen, David Wang, Yilong Wang, Yonghong Zhang, Jiang He, Yongjun Wang, Liping Liu · 发表于：Stroke · 年份：2025 · DOI：10.1161/strokeaha.124.049242 · 被引用次数：5 · 研究领域：Acute Ischemic Stroke Management、Blood Pressure and Hypertension Studies、Dementia and Cognitive Impairment Research

BACKGROUND: We performed a prespecified subgroup analysis of the CATIS-2 trial (China Antihypertensive Trial in Acute Ischemic Stroke II) to compare the effect of early versus delayed antihypertensive treatment on death and disability in patients with and without medical history of hypertension. METHODS: CATIS-2 is a multicenter randomized clinical trial conducted in 106 hospitals in China. The trial randomized 4810 patients with acute ischemic stroke within 24 to 48 hours of symptom onset and elevated systolic blood pressure between 140 and <220 mm Hg to receive antihypertensive treatment immediately after randomization or to discontinue antihypertensive medications for 7 days and then receive treatment on day 8. The primary outcome was a combination of death or functional dependency (modified Rankin Scale score ≥3) at 90 days. RESULTS: At the 90-day follow-up, the primary outcome of death or functional dependency was not different between early- and delayed-treatment groups according to the history of hypertension; the odds ratios (95% CIs) associated with the early-treatment group were 1.11 (0.91–1.36) and 1.38 (0.92–2.08) for participants with and without a history of hypertension. However, the ordinal logistic regression showed that early antihypertensive treatment was associated with the odds of a higher modified Rankin Scale score in patients without hypertension (odds ratio, 1.35 [95% CI, 1.01–1.82]), but not in those with hypertension (odds ratio, 0.95 [95% CI, 0....