Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Patients With Acute Ischemic StrokeThe CATIS Randomized Clinical Trial

Por: Jiang He, MD, PhD, Yonghong Zhang, MD, PhD, Tan Xu, MD, PhD, Qi Zhao, MD, PhD, Dali Wang, MD,; Chung-Shiuan Chen, MS, Weijun Tong, MD, Changjie Liu, MD, Tian Xu, MD, Zhong Ju, MD, Yanbo Peng, MD, Hao Peng, MD1; Qunwei Li, MD8; Deqin Geng, MD9; Jintao Zhang, MD10; Dong Li, MD11; Fengshan Zhang, MD,; Libing Guo, MD, Yingxian Sun, MD, Xuemei Wang, MD, Yong Cui, MD, Yongqiu Li, MD, Dihui Ma, MD, Guang Yang, MD, Yanjun Gao, MD,  Xiaodong Yuan, MD, Lydia A. Bazzano, MD, PhD, Jing Chen, MD, MS, for the CATIS Investigators.  JAMA, February 5, 2014, Vol 311, No. 5.

Although the benefit of reducing blood pressure for primary and secondary prevention of stroke has been established, the effect of antihypertensive treatment in patients with acute ischemic stroke is uncertain.
To evaluate whether immediate blood pressure reduction in patients with acute ischemic stroke would reduce death and major disability at 14 days or hospital discharge.
The China Antihypertensive Trial in Acute Ischemic Stroke, a single-blind, blinded end-points randomized clinical trial, conducted among 4071 patients with nonthrombolysed ischemic stroke within 48 hours of onset
and elevated systolic blood pressure. Patients were recruited from 26 hospitals across China between August 2009 and May 2013. Primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 14 days or hospital discharge. Among patients with acute ischemic stroke, blood pressure reduction with antihypertensive medications, compared with the absence of hypertensive medication, did not reduce the likelihood of death and major disability at 14 days or hospital discharge.

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