under 2 months ago in a large meta-analysis demonstrating that even pre-hypertension is associated with an increase risk of initial (incident) stroke.When it comes to primary prevention of strokes, lower blood pressure has always been key. This was confirmed just
But in a surprising turn around (surprising, at least, to me), JAMA released an observational study this week in which 20,330 patients who'd had a recent stroke were followed for 2+yrs after which the authors concluded that those with a systolic blood pressure of 130-140mm Hg had the lowest risk of recurrent stroke, compared to both very low normal (<120mm Hg), low normal (120-130mm Hg), high (140-150mm Hg), and very high (>150mm Hg) blood pressure.
Remember, this was an observational study. Moreover, it was a post-hoc analysis. In other words, the original authors weren't even looking for this finding in the original study. Therefore, the conclusion is only good for generating hypotheses, not for dictating care guidelines. But in a broad sense, it's certainly consistent with the ACCORD findings that we don't necessarily have to strive for the lowest. So this is where the art of medicine kicks in . . .