@article { , title = {Associations between change in blood pressure and functional outcome, early events and death: results from the Efficacy of Nitric Oxide in Stroke trial}, abstract = {Objectives: High blood pressure (BP) is associated with a poor outcome after acute stroke. Early reduction in blood pressure (BP) may be associated with fewer early adverse events and deaths, and improved functional outcome. Methods: Analyses used data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial, a multicentre randomised single-masked and outcome-masked trial of glyceryl trinitrate (GTN) vs. no GTN in 4,011 patients recruited within 48 hours of an ischaemic or haemorrhagic stroke and with raised systolic BP (SBP 140-220mmHg). Change in SBP from baseline to day 1 was categorised as: >15\% decrease, 15-5\% decrease, 5\% decrease to 5\% increase (no change - reference), and >5\% increase. The primary outcome was functional outcome (modified Rankin Scale [mRS]) score at 90 days. Results: Across all patients, both moderate (5–15\%) and large (>15\%) decreases in SBP were associated with beneficial shifts in the mRS relative to patients with no change in blood pressure: adjusted common odds ratio (acOR) 0.81 (95\% CI 0.70–0.90) and OR 0.84 (95\% CI 0.71–1.00) respectively. A moderate decrease in SBP was also associated with a lower risk of early adverse events, aOR 0.69 (95\% CI 0.52–0.90). Conclusion: Modest decreases in SBP in acute stroke appear to be associated with fewer early events and better long-term functional outcome.}, doi = {10.1097/HJH.0000000000002154}, eissn = {1473-5598}, issue = {10}, journal = {Journal of Hypertension}, pages = {2104-2109}, publicationstatus = {Published}, publisher = {Lippincott, Williams \& Wilkins}, url = {https://nottingham-repository.worktribe.com/output/2025896}, volume = {37}, keyword = {Acute stroke, blood pressure, glyceryl trinitrate}, year = {2019}, author = {Sandset, Else C. and Appleton, Jason P. and Berge, Eivind and Christensen, Hanne and Gommans, John and Krishnan, Kailash and Ntaios, George and Phillips, Stephen and Pocock, Stuart and Sprigg, Nikola and Woodhouse, Lisa J. and Bath, Philip M.} }