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In a sub-analysis of a randomized controlled trial (CSPS.com), patients between 8 and 180 days after stroke onset were randomly assigned to receive aspirin or clopidogrel alone, or a combination of cilostazol with aspirin or clopidogrel. The percent changes, differences, and raw values of follow-up BP were examined. The primary efficacy outcome was the first recurrence of ischemic stroke. In a total of 1657 patients (69.5\u2009\u00b1\u20099.3 years, female 29.1%) with median 1.5-year follow-up, ischemic stroke recurred in 74 patients. The adjusted hazard ratio for ischemic stroke of a 10% systolic BP (SBP) increase from baseline was 1.19 (95% CI 1.03\u20131.36), that of a 10\u2009mmHg SBP increase was 1.14 (1.03\u20131.28), and that of SBP as the raw value with the baseline SBP as a fixed (time-independent) covariate was 1.14 (1.00\u20131.31). Such significant associations were not observed in diastolic BP-derived variables. The estimated adjusted hazard ratio curves for the outcome showed the benefit of dual therapy over a wide SBP range between \u2248120 and \u2248165\u2009mmHg uniformly. Lower long-term SBP levels after ischemic stroke were associated with a lower risk of subsequent ischemic events. The efficacy of dual antiplatelet therapy including cilostazol for secondary stroke prevention was evident over a wide SBP range.<\/jats:p>","DOI":"10.1038\/s41440-024-01742-3","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T01:01:59Z","timestamp":1720486919000},"page":"2238-2249","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Blood pressure during long-term cilostazol-based dual antiplatelet therapy after stroke: a post hoc analysis of the CSPS.com 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Toyoda reports honoraria from Otsuka Pharmaceutical, Daiichi-Sankyo, Bristol-Myers-Squibb, Bayer Yakuhin, and Janssen. Koga reports honoraria from Bayer Yakuhin, Daiichi-Sankyo, Mitsubishi Tanabe Pharma Corporation, and research support from, Daiichi-Sankyo, Nippon Boehringer Ingelheim. Hoshino reports honoraria from Otsuka Pharmaceutical, Bristol-Myers-Squibb and Pfizer. Okada reports honoraria from Daiichi-Sankyo and Pfizer. Sakai reports a research grant from Biomedical Solutions, Medtronic, Terumo and TG Medical; lecturer\u2019s fees from Asahi-Intec, Biomedical Solutions, Daiichi Sankyo, Kaneka, Medtronic, Stryker and Terumo; and membership on the advisory boards for Johnson & Johnson, Medtronic and Terumo. Minematsu reports honoraria from Bayer Yakuhin and Pfizer. None of the other authors have any conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}