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High blood pressure increases the risk of bleeding during antithrombosis medication.
, however, the relationship between blood pressure levels and the risk of relapsed stroke during long-term prevention of secondary stroke using pyridine (especially Pragre) has not been well studied.
the randomized, double-blind, multi-center PRASTRO-I trial (a comparative trial of pragray and clopidogrere efficacy in patients with ischemic stroke I in Japan).
patients with non-cardiac embolism stroke were randomly assigned (1:1) to receive Pragre 3.75 mg/day or clopidogre 75 mg/day for 96 to 104 weeks of continuous treatment.
the risk of ischemic or hemorrhagic stroke, combined ischemic events, and combined bleeding events was determined based on the average systolic pressure (SBP) and follow-up variability (including continuous variability) during observation.
these risks were also compared between the average systolic level and the four-digit constant change in systolic pressure.
the study involved 3,747 patients (aged 62.1±8.5 years and 797 women) with an average SBP level of 132.5 mmHg during the observation period.
all strokes (146; risk ratio is 1.318 (95% CI is 1.094-1.583)/10mmHg), ischemic stroke (133 cases, 1.219 (1.010-1.466)), hemorrhagic stroke (13 cases, 3.3.) 247 (1.660-6.296), isoemia events (142 cases, 1.219 (1.020-1.466), bleeding events (47 cases, 1.629 (1.172-2.261)) risk was associated with an overall SBP increase.
, the increased risk of these events is associated with an increase in continuous changes in SBP (for each additional 10mmHg, the corresponding risk ratio is 3.078 (95% CI is 2.220-4.225) and 3.051 (2.179-4.4.) 262); 3.276 (1.172-9.092); 2.865 (2.042-4.011); 2.764 (1.524-5.016).
there was no difference in the event rate between the Clopidogrera and Pragre groups within the SBP quetum or continuous changes in SBP.
result, high average SBP levels and follow-up variability were significantly associated with the risk of stroke recurrence during long-term treatment of Pragre or clopidogrere.
control of high blood pressure is particularly important, regardless of the type of antiplate plateboard drug used.
