Park JH, et al. – Researchers planned this study to investigate the relationship of diastolic BP (DBP) level with vascular outcomes after a stroke. Among patients after recent noncardioembolic stroke, DBP levels in the low–normal range conferred increased risk of major vascular events (MVEs) and stroke, especially accompanied by an increased pulse pressure (PP) of >60.

• For this study, the researchers examined a multicenter trial data set involving 3680 recent (<4 months) noncardioembolic stroke patients followed for 2 years.
• During follow-up, subjects were categorized per mean DBP level (mmHg): low-normal (<70), normal (70-<80), high-normal (80-89), and high (≥90).
• They prespecified pulse pressure (PP) by 3 categories of <60; 60-<70; and ≥70 mmHg.
• They evaluated independent associations of mean DBP level with major vascular events (MVEs) and ischemic stroke.

• The researchers observed MVEs in 20.7% of the low-normal, 15.1% of the normal, 16.9% of the high-normal, and 19.2% of the high DBP groups; while stroke occurred in 9.9%, 6.8%, 8.5%, and 10.8%, respectively.
• Risk of MVEs was higher in the low-normal DBP group compared with the normal DBP group (adjusted hazard ratio [AHR], 1.33; 95% CI, 1.04–1.71).
• Risk of MVEs (1.89; 1.13-3.15), and stroke (2.87; 1.48-5.53) was higher in subjects with PP ≥70 (mean DBP, 62.4±3.8) compared to those with the lowest PP (mean DBP, 78.0±5.9) among those with SBP 120-<140 mmHg; while among those with SBP <120 mmHg, PP 60-<70 (mean DBP, 52.7±2.5) was correlated with increased risk of stroke (5.85; 1.25-27.5).