A lower systolic blood-pressure target reduced major cardiovascular events among stroke and transient ischemic attack survivors in Brazil, according to OPTIMAL-Stroke results released November 7 by the American Heart Association.
The randomized trial enrolled 4,368 adults at 30 Brazilian centers. It compared treatment targeting systolic pressure below 120 mm Hg with a target below 140 mm Hg over an average 3.9 years.
Major cardiovascular events occurred in 10.9% of the intensive-treatment group and 13.5% receiving standard treatment, a relative risk reduction of about 21%. Recurrent strokes occurred in 4.7% and 6.4%, respectively.
Overall serious adverse events were similar, but kidney-related events were more frequent with intensive treatment. Researchers emphasized medical supervision and kidney monitoring.
Not everyone assigned intensive treatment reached its target. Findings may not generalize beyond Brazil, where care and environmental conditions differ. The association said the trial was simultaneously published in the New England Journal of Medicine. These results describe the study’s treatment comparison; they do not establish one blood-pressure target for every stroke survivor.