{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:25:58Z","timestamp":1790799958376,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007543","name":"Agence Nationale de S\u00e9curit\u00e9 du M\u00e9dicament et des Produits de Sant\u00e9","doi-asserted-by":"publisher","award":["2019S015 and 2024S001"],"award-info":[{"award-number":["2019S015 and 2024S001"]}],"id":[{"id":"10.13039\/501100007543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,1]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of various antihypertensive drugs on secondary stroke prevention in a real-life setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nationwide historic cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>French healthcare system data (SNDS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults hospitalised for ischaemic stroke between 2014 and 2015 were followed up until December 2021 and stratified based on the presence of atrial fibrillation (AF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Risk of stroke recurrence was assessed using a time-dependent Cox cause-specific model accounting for changes in drug exposure. We also investigated the risk of major adverse cardiovascular events (MACE) or all-cause death. Models were adjusted on stroke characteristics, coprescriptions and co-morbidities, at inclusion and across follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 54\u2009764 patients without AF (median age 71; 46%\u2009women) and 17\u2009960 with AF (median age 79; 51%\u2009women), stroke recurrence occurred in 11% and 13%, respectively. In non-AF patients, reduced recurrence risk was associated only with use of calcium channel blockers (adjusted HR (aHR) 0.91, 95%\u2009CI 0.86 to 0.97), thiazide diuretics (aHR 0.90, 95%\u2009CI 0. 83 to 0.97), loop diuretics (aHR 0.86, 95%\u2009CI 0.77 to 0.95) and potassium-sparing agents (aHR 0.83, 95%\u2009CI 0.70 to 0.98). In AF patients, only potassium-sparing agents (aHR 0.82, 95%\u2009CI 0.69 to 0.99) were associated with reduced recurrence risk. All antihypertensive drugs, apart from loop diuretics, were associated with a reduced risk of MACE or all-cause death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large cohort, only diuretics and calcium channel blockers were associated with a reduced risk of recurrent stroke. Most antihypertensive drugs, however, may be more effective in overall cardiovascular prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107816","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T05:30:16Z","timestamp":1765863016000},"page":"e107816","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of antihypertensive drugs for secondary prevention of ischaemic stroke: a nationwide historic cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3973-7168","authenticated-orcid":false,"given":"Julia","family":"Perrier","sequence":"first","affiliation":[{"name":"INSERM U1219, BPH, AHeaD team, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6517-2984","authenticated-orcid":false,"given":"Christophe","family":"Tzourio","sequence":"additional","affiliation":[{"name":"INSERM U1219, BPH, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France"},{"name":"CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Bezin","sequence":"additional","affiliation":[{"name":"INSERM U1219, BPH, AHeaD team, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France"},{"name":"Medical Pharmacology Department, CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"2026010703471526000_15.12.e107816.1","doi-asserted-by":"crossref","first-page":"I","DOI":"10.1177\/23969873221100032","article-title":"European Stroke 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