Stroke; a journal of cerebral circulation
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis.
High blood pressure (BP) is common in acute ischemic stroke and associated independently with a poor functional outcome. However, the management of BP acutely remains unclear because no large trials have been completed. ⋯ Treatment with telmisartan in 1360 patients with acute mild ischemic stroke and mildly elevated BP appeared to be safe with no excess in adverse events, was not associated with a significant effect on functional dependency, death, or recurrence, and modestly lowered BP.
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Randomized Controlled Trial Multicenter Study Comparative Study
Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: living well with stroke: randomized, controlled trial.
Depression after stroke is prevalent, diminishing recovery and quality of life. Brief behavioral intervention, adjunctive to antidepressant therapy, has not been well evaluated for long-term efficacy in those with poststroke depression. ⋯ A brief psychosocial-behavioral intervention is highly effective in reducing depression in both the short and long term.
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A number of factors have been associated with postthrombolysis intracerebral hemorrhage, but these have varied across studies. ⋯ Along with higher National Institutes of Health Stroke Scale and extensive early CT changes, baseline antiplatelet use (particularly double antiplatelet therapy) was associated with an increased risk of post-tissue plasminogen activator symptomatic intracerebral hemorrhage. Of these factors, only National Institutes of Health Stroke Scale was associated with clinical outcome.
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Randomized Controlled Trial Multicenter Study
Quality of life after intracerebral hemorrhage: results of the Factor Seven for Acute Hemorrhagic Stroke (FAST) trial.
Neurological impairment and physical disability are frequent and important complications of stroke with serious consequences for health-related quality of life (HRQOL). Little data exist, however, on the risk factors for poor HRQOL after intracerebral hemorrhage, the deadliest and most disabling form of stroke. ⋯ The vast majority of survivors after intracerebral hemorrhage have very poor HRQOL. Critical care interventions designed to control blood pressure or prevent neuroworsening may improve HRQOL in intracerebral hemorrhage survivors.
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Multicenter Study
Applying the evidence: do patients with stroke, coronary artery disease, or both achieve similar treatment goals?
The importance of early and aggressive initiation of secondary prevention strategies for patients with both coronary artery disease (CAD) and cerebrovascular disease (CVD) is emphasized by multiple guidelines. However, limited information is available on cardiovascular protection and stroke prevention in an outpatient setting from community-based populations. We sought to evaluate and compare differences in treatment patterns and the attainment of current guideline-recommended targets in unselected high-risk ambulatory patients with CAD, CVD, or both. ⋯ Despite the proven benefits of available antihypertensive and lipid-lowering therapies, current management of hypertension and dyslipidemia continues to be suboptimal. A considerable proportion of patients failed to achieve guideline-recommended targets, and this apparent treatment gap was more pronounced among patients with CVD and women. Quality improvement strategies should target these patient subgroups.