{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["6(3)"],"submitter":["Mazzucco S"],"funding":["Wolfson Foundation","National Institute for Health Research Oxford Biomedical Research Centre","Wellcome Trust"],"pubmed_abstract":["<h4>Introduction</h4>There is limited knowledge of the effects of blood pressure (BP) lowering on cerebral haemodynamics after transient ischaemic attack (TIA) and non-disabling stroke, particularly at older ages. We aimed to evaluate changes in transcranial Doppler (TCD) haemodynamic indices in patients undergoing early blood pressure lowering after TIA/non-disabling stroke, irrespective of age.<h4>Patients and methods</h4>Among consecutive eligible patients attending a rapid-access clinic with suspected TIA/non-disabling stroke and no evidence of extra/intracranial stenosis, hypertensive ones underwent intensive BP-lowering guided by daily home telemetric blood pressure monitoring (HBPM). Clinic-based BP, HBPM, End-tidal CO<sub>2</sub> and bilateral middle cerebral artery (MCA) velocity on TCD were compared in the acute setting versus one-month follow-up; changes were stratified by baseline hypertension (clinic-BP≥140/90) and by age (<65, 65-79 and ≥80).<h4>Results</h4>In 697 patients with repeated TCD measures, mean/SD baseline systolic-BP (145.0/21.3 mmHg) was reduced by an average of 11.3/19.9 mmHg (<i>p</i> < 0.0001) at one-month (133.7/17.4 mmHg), driven by patients hypertensive at baseline (systolic-BP change = -19.0/19.2 mmHg, <i>p</i> < 0.001; vs -0.5/15.4, <i>p</i> = 0.62 in normotensives). Compared with baseline, a significant change was observed at one-month only in mean/SD MCA end diastolic velocity (EDV) (0.77/7.26 cm/s, <i>p</i> = 0.005) and in resistance index (RI) (-0.005/0.051, <i>p</i> = 0.016), driven by hypertensive patients (mean/SD EDV change: 1.145/6.96 cm/s <i>p</i> = 0.001, RI change -0.007/0.06, <i>p</i> = 0.014). Findings were similar at all ages (EDV change - p<sub>trend</sub>=0.357; RI change - p<sub>trend</sub>=0.225), including 117 patients aged ≥80. EDV and RI changes were largest in 100 patients with clinic systolic-BP decrease ≥30 mmHg (mean/SD EDV change = 2.49/7.47 cm/s, <i>p</i> = 0.001; RI change -0.024/0.063, <i>p</i> < 0.0001).<h4>Conclusion</h4>There was no evidence of worsening of TCD haemodynamic indices associated with BP-lowering soon after TIA/non-disabling stroke, irrespective of age and degree of BP reduction. In fact, EDV increase and RI decrease observed after treatment of hypertensive patients suggest a decrease in distal vascular resistance."],"journal":["European stroke journal"],"pagination":["245-253"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC8564162"],"repository":["biostudies-literature"],"pubmed_title":["Age-specific cerebral haemodynamic effects of early blood pressure lowering after transient ischaemic attack and non-disabling stroke."],"pmcid":["PMC8564162"],"pubmed_authors":["Oxford Vascular Study Phenotyped cohort","Mazzucco S","Brunelli N","Rothwell PM","Binney LE","McGurgan IJ","Li L","Tuna MA"],"additional_accession":[]},"is_claimable":false,"name":"Age-specific cerebral haemodynamic effects of early blood pressure lowering after transient ischaemic attack and non-disabling stroke.","description":"<h4>Introduction</h4>There is limited knowledge of the effects of blood pressure (BP) lowering on cerebral haemodynamics after transient ischaemic attack (TIA) and non-disabling stroke, particularly at older ages. We aimed to evaluate changes in transcranial Doppler (TCD) haemodynamic indices in patients undergoing early blood pressure lowering after TIA/non-disabling stroke, irrespective of age.<h4>Patients and methods</h4>Among consecutive eligible patients attending a rapid-access clinic with suspected TIA/non-disabling stroke and no evidence of extra/intracranial stenosis, hypertensive ones underwent intensive BP-lowering guided by daily home telemetric blood pressure monitoring (HBPM). Clinic-based BP, HBPM, End-tidal CO<sub>2</sub> and bilateral middle cerebral artery (MCA) velocity on TCD were compared in the acute setting versus one-month follow-up; changes were stratified by baseline hypertension (clinic-BP≥140/90) and by age (<65, 65-79 and ≥80).<h4>Results</h4>In 697 patients with repeated TCD measures, mean/SD baseline systolic-BP (145.0/21.3 mmHg) was reduced by an average of 11.3/19.9 mmHg (<i>p</i> < 0.0001) at one-month (133.7/17.4 mmHg), driven by patients hypertensive at baseline (systolic-BP change = -19.0/19.2 mmHg, <i>p</i> < 0.001; vs -0.5/15.4, <i>p</i> = 0.62 in normotensives). Compared with baseline, a significant change was observed at one-month only in mean/SD MCA end diastolic velocity (EDV) (0.77/7.26 cm/s, <i>p</i> = 0.005) and in resistance index (RI) (-0.005/0.051, <i>p</i> = 0.016), driven by hypertensive patients (mean/SD EDV change: 1.145/6.96 cm/s <i>p</i> = 0.001, RI change -0.007/0.06, <i>p</i> = 0.014). Findings were similar at all ages (EDV change - p<sub>trend</sub>=0.357; RI change - p<sub>trend</sub>=0.225), including 117 patients aged ≥80. EDV and RI changes were largest in 100 patients with clinic systolic-BP decrease ≥30 mmHg (mean/SD EDV change = 2.49/7.47 cm/s, <i>p</i> = 0.001; RI change -0.024/0.063, <i>p</i> < 0.0001).<h4>Conclusion</h4>There was no evidence of worsening of TCD haemodynamic indices associated with BP-lowering soon after TIA/non-disabling stroke, irrespective of age and degree of BP reduction. In fact, EDV increase and RI decrease observed after treatment of hypertensive patients suggest a decrease in distal vascular resistance.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021 Sep","modification":"2026-06-02T18:30:04.787Z","creation":"2025-04-04T14:53:27.828Z"},"accession":"S-EPMC8564162","cross_references":{"pubmed":["34746420"],"doi":["10.1177/23969873211039716"]}}