Low Blood Pressure, Comorbidities, and Ischemic Stroke Mortality in US Veterans

Low blood pressure (BP) is associated with higher stroke mortality, although the factors underlying this association have not been fully explored. We investigated prestroke BP and long-term mortality after ischemic stroke in a national sample of US veterans. Using a retrospective cohort study design...

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Bibliographic Details
Published in:Stroke (1970) 2022-03, Vol.53 (3), p.886-894
Main Authors: Aparicio, Hugo J., Tarko, Laura M., Gagnon, David, Costa, Lauren, Galloway, Ashley, Demissie, Serkalem, Djousse, Luc, Seshadri, Sudha, Cho, Kelly, Wilson, Peter W.F.
Format: Article
Language:English
Subjects:
Aged
Comorbidity
Female
Humans
Hypotension - mortality
Hypotension - physiopathology
Ischemic Stroke - mortality
Ischemic Stroke - physiopathology
Male
Middle Aged
Retrospective Studies
United States
Veterans
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Summary:Low blood pressure (BP) is associated with higher stroke mortality, although the factors underlying this association have not been fully explored. We investigated prestroke BP and long-term mortality after ischemic stroke in a national sample of US veterans. Using a retrospective cohort study design of veterans hospitalized between 2002 and 2007 with a first ischemic stroke and with ≥1 outpatient BP measurements 1 to 18 months before admission, we defined 6 categories each of average prestroke systolic BP (SBP) and diastolic BP, and 7 categories of pulse pressure. Patients were followed-up to 12 years for primary outcomes of all-cause and cardiovascular mortality. We used Cox models to relate prestroke BP indices to mortality and stratified analyses by the presence of preexisting comorbidities (smoking, myocardial infarction, heart failure, atrial fibrillation/flutter, cancer, and dementia), race and ethnicity. Of 29 690 eligible veterans with stroke (mean±SD age 67±12 years, 98% men, 67% White), 2989 (10%) had average prestroke SBP
ISSN:0039-2499
1524-4628
1524-4628
DOI:10.1161/STROKEAHA.120.033195