{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:01:55Z","timestamp":1757700115118,"version":"3.41.2"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,3]]},"abstract":"\n Background<\/jats:title>\n \n We aimed to test the impact of achieved blood pressure (\n BP<\/jats:styled-content>\n ) on first stroke among patients with grade 1 hypertension and without cardiovascular diseases in the China Stroke Primary Prevention Trial.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A total of 3187 patients with uncomplicated grade 1 hypertension were included. The risk of outcomes was assessed according to: (1) the proportion of visits in which\n BP<\/jats:styled-content>\n was reduced to <140\/90\u00a0mm\u00a0Hg, and (2) the time\u2010averaged systolic BP (\n SBP<\/jats:styled-content>\n ) or diastolic BP levels during the study treatment period. The median antihypertensive treatment duration was 4.6\u00a0years. Only 1.5% of the participants discontinued the treatments because of adverse reaction. Overall, the risk of stroke decreased with the increase of the proportion of study visits with\n BP<\/jats:styled-content>\n <140\/90\u00a0mm\u00a0Hg (for per 5% increase; hazard ratio, 0.92 [95%\n CI<\/jats:styled-content>\n , 0.87\u20130.98]). Consistently, compared with patients with time\u2010averaged\n SBP<\/jats:styled-content>\n \u2265140 or diastolic BP \u226590\u00a0mm\u00a0Hg, the risk of stroke was lower in patients with time\u2010averaged\n SBP<\/jats:styled-content>\n of 120 to <140\u00a0mm\u00a0Hg (1.1% versus 2.9%; hazard ratio, 0.39 [95%\n CI<\/jats:styled-content>\n , 0.22\u20130.69]) or diastolic BP <90\u00a0mm\u00a0Hg (1.5% versus 2.7%; hazard ratio, 0.41 [95%\n CI<\/jats:styled-content>\n , 0.17\u20130.98]). The beneficial results were consistent across age (<60 versus \u226560\u00a0years), sex, baseline\n SBP<\/jats:styled-content>\n (<150 versus 150 to <160\u00a0mm\u00a0Hg), study treatment groups (enalapril or enalapril\u2010folic acid), and hypertension subtypes (isolated systolic hypertension or systolic\u2010diastolic hypertension). However, a time\u2010averaged\n SBP<\/jats:styled-content>\n <120\u00a0mm\u00a0Hg (versus 120\u2013140\u00a0mm\u00a0Hg) was associated with an increased risk for stroke. Similar results were observed for composite cardiovascular events or all\u2010cause death.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Achieved\n BP<\/jats:styled-content>\n <140\/90\u00a0mm\u00a0Hg was significantly associated with a decreased risk of stroke or all\u2010cause death in patients with uncomplicated grade 1 hypertension.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.005247","type":"journal-article","created":{"date-parts":[[2017,3,9]],"date-time":"2017-03-09T01:45:44Z","timestamp":1489023944000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of Achieved Blood Pressure on First Stroke in Uncomplicated Grade 1 Hypertension"],"prefix":"10.1161","volume":"6","author":[{"given":"Xianhui","family":"Qin","sequence":"first","affiliation":[{"name":"State Key Laboratory of Organ Failure Research Renal Division National Clinical Research Center for Kidney Disease Guangdong Provincial Institute of Nephrology Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youbao","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organ Failure Research Renal Division National Clinical Research Center for Kidney Disease Guangdong Provincial Institute of Nephrology Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ningling","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiology Peking University People's Hospital Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingli","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurology First People's Hospital Lianyungang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genfu","family":"Tang","sequence":"additional","affiliation":[{"name":"Institute for Biomedicine Anhui Medical University Hefei China"},{"name":"School of Health Administration Anhui Medical University Hefei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delu","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Cardiology First People's Hospital Lianyungang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JiGuang","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Hypertension Department of Hypertension Centre for Epidemiological Studies and Clinical Trials The Shanghai Institute of Hypertension Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Liang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organ Failure Research Renal Division National Clinical Research Center for Kidney Disease Guangdong Provincial Institute of Nephrology Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binyan","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organ Failure Research Renal Division National Clinical Research Center for Kidney Disease Guangdong Provincial Institute of Nephrology Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Peking University First Hospital Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Xu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organ Failure Research Renal Division National Clinical Research Center for Kidney Disease Guangdong Provincial Institute of Nephrology Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiping","family":"Xu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organ Failure Research Renal Division National Clinical Research Center for Kidney Disease Guangdong Provincial Institute of Nephrology Nanfang Hospital Southern Medical University Guangzhou China"},{"name":"AUSA Research Institute Shenzhen AUSA Pharmed Co Ltd Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan Fan","family":"Hou","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organ Failure Research Renal Division National Clinical Research Center for Kidney Disease Guangdong Provincial Institute of Nephrology Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)17741-1"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.37.3.869"},{"key":"e_1_3_1_4_2","first-page":"CD006742","article-title":"Pharmacotherapy for mild hypertension","volume":"8","author":"Diao D","year":"2012","unstructured":"Diao D, Wright JM, Cundiff DK, Gueyffier F. Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev. 2012;8:CD006742.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjh.0000431740.32696.cc"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000065"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.284427"},{"key":"e_1_3_1_8_2","unstructured":"National Institute for Health and Clinical Excellence . Hypertension (CG127): clinical management of primary hypertension in adults. Available at: http:\/\/www.nice.org.uk\/guidance\/cg127. Accessed August 2011."},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.02.066"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2015.1040761"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.2274"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv633"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0773"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000379"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr039"},{"key":"e_1_3_1_16_2","first-page":"27","volume-title":"Clinical Trials in Hypertension","author":"Davis BR","year":"2001","unstructured":"Davis BR, Ford CE. The hypertension detection follow\u2010up program. In: Black HR, ed. Clinical Trials in Hypertension. New York, NY: Marcel Dekker, Inc.; 2001:27\u201360."},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(80)90438-6"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510060059034"},{"key":"e_1_3_1_19_2","first-page":"I98","article-title":"Treatment of mild hypertension: results of a ten\u2010year intervention trial","volume":"40","author":"Smith WM","year":"1977","unstructured":"Smith WM. Treatment of mild hypertension: results of a ten\u2010year intervention trial. Circ Res. 1977;40:I98\u2013I105.","journal-title":"Circ Res"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.07738"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1650"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.884"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001286"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.07257"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000254"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.005247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:24:47Z","timestamp":1715595887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.005247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1161\/JAHA.116.005247"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.005247","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2017,3]]},"assertion":[{"value":"2016-12-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e005247"}}