2024
Secondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts
Rivier C, Acosta J, Leasure A, Forman R, Sharma R, de Havenon A, Spatz E, Inzucchi S, Kernan W, Falcone G, Sheth K. Secondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts. Journal Of The American Heart Association 2024, 13: e033322. PMID: 38639369, PMCID: PMC11179946, DOI: 10.1161/jaha.123.033322.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureCross-Sectional StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsPractice Guidelines as TopicRisk AssessmentRisk FactorsSecondary PreventionStrokeUnited KingdomUnited StatesConceptsMyocardial infarctionPrevention scoreSecondary preventionImplementation of preventive therapyNational cohortUK BiobankAntiplatelet therapy useGuideline-directed therapyPrevention profilesBlood pressure controlAdherence to guideline-directed therapyLow-density lipoprotein controlNeighborhood deprivation levelHistory of strokeVascular risk profileStatin useAntiplatelet useTherapy usePreventive therapyComparison to participantsPrevention criteriaCross-sectional analysisBlood pressurePatientsPressure control
2023
Impact of Therapeutic Interventions on Cerebral Autoregulatory Function Following Severe Traumatic Brain Injury: A Secondary Analysis of the BOOST-II Study
Prasad A, Gilmore E, Kim J, Begunova L, Olexa M, Beekman R, Falcone G, Matouk C, Ortega-Gutierrez S, Temkin N, Barber J, Diaz-Arrastia R, de Havenon A, Petersen N. Impact of Therapeutic Interventions on Cerebral Autoregulatory Function Following Severe Traumatic Brain Injury: A Secondary Analysis of the BOOST-II Study. Neurocritical Care 2023, 41: 91-99. PMID: 38158481, PMCID: PMC11285118, DOI: 10.1007/s12028-023-01896-x.Peer-Reviewed Original ResearchCerebral perfusion pressureBrain tissue hypoxiaSevere traumatic brain injuryTissue hypoxiaTraumatic brain injuryBlood pressureCerebral hypoperfusionBrain injuryAutoregulatory functionMean cerebral perfusion pressureSecondary analysisOptimal cerebral perfusion pressurePercent timeCerebral autoregulatory functionLimits of autoregulationPhase II trialArterial blood pressureBrain tissue oxygenIntracranial pressure monitoringCPP augmentationHemodynamic augmentationAutoregulatory indexII trialBP managementPerfusion pressurePolygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors
Acosta J, Both C, Demarais Z, Conlon C, Leasure A, Torres-Lopez V, de Havenon A, Petersen N, Gill T, Sansing L, Sheth K, Falcone G. Polygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors. Neurology 2023, 100: e1587-e1597. PMID: 36690452, PMCID: PMC10103110, DOI: 10.1212/wnl.0000000000206763.Peer-Reviewed Original ResearchConceptsWorse BP controlUncontrolled blood pressureDiastolic blood pressureBlood pressureStroke survivorsPolygenic risk scoresBP controlPolygenic susceptibilityMean diastolic blood pressureMean systolic blood pressureStroke Prevention TrialBlood pressure controlSystolic blood pressureResistant hypertensionVascular eventsHemorrhagic strokePrevention trialsVitamin InterventionMultivariable modelRisk scoreGenetic predispositionPressure controlLogistic regressionSurvivorsHypertension
2022
Technical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly.
Forman R, Viscoli C, Meurer K, Sheth K, Sansing L, de Havenon A, Sharma R, Mariscal M, Kernan W. Technical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly. American Journal Of Hypertension 2022, 36: 195-200. PMID: 36520024, PMCID: PMC10016067, DOI: 10.1093/ajh/hpac129.Peer-Reviewed Original ResearchConceptsHome blood pressure monitoringBlood pressure monitoringBlood pressurePressure monitoringNon-Hispanic white patientsProportion of patientsCross-sectional studyNon-Hispanic white participantsStroke recurrenceRate of useMost patientsPrimary outcomeWhite patientsRate of possessionPatientsUnderrepresented patientsArm cuffHypertensionStrokeCorrect useWhite participantsSignificant disparitiesEthnic groupsParticipantsQuality of techniqueBaseline Serum Biomarkers of Inflammation and Subsequent Visit-to-Visit Blood Pressure Variability: A Post Hoc Analysis of MESA
Wong KH, Muddasani V, Peterson C, Sheibani N, Arkin C, Cheong I, Majersik JJ, Biffi A, Petersen N, Falcone GJ, Sansing LH, de Havenon AH. Baseline Serum Biomarkers of Inflammation and Subsequent Visit-to-Visit Blood Pressure Variability: A Post Hoc Analysis of MESA. American Journal Of Hypertension 2022, 36: 144-147. PMID: 36315490, PMCID: PMC11484580, DOI: 10.1093/ajh/hpac122.Peer-Reviewed Original ResearchConceptsBlood pressure variabilityHigh blood pressure variabilitySerum inflammatory markersPlasmin-antiplasmin complexC-reactive proteinInterleukin-6Inflammatory markersBlood pressureStudy visitPressure variabilityBaseline serum IL-6Visit blood pressure variabilityLipid-lowering medicationsMean blood pressureSerum IL-6Markers of inflammationSystolic blood pressureBaseline study visitBody mass indexOnly IL-6Major vascular diseasesMulti-Ethnic StudyBaseline serum biomarkersPatient age categoryPost Hoc AnalysisSafety and efficacy of intensive systolic blood pressure lowering after successful endovascular therapy: a post hoc analysis of the BP TARGET trial
Anadani M, Maier B, Escalard S, Labreuche J, de Havenon A, Sabben C, Lapergue B, Mistry EA, Gory B, Spiotta AM, Richard S, Sibon I, Desilles JP, Blanc R, Piotin M, Mazighi M. Safety and efficacy of intensive systolic blood pressure lowering after successful endovascular therapy: a post hoc analysis of the BP TARGET trial. Journal Of NeuroInterventional Surgery 2022, 15: e142-e147. PMID: 36220337, DOI: 10.1136/jnis-2022-019130.Peer-Reviewed Original ResearchConceptsIntensive SBP treatmentHistory of hypertensionBlood pressure treatmentSuccessful endovascular therapyIntravenous thrombolysisLocation of occlusionEndovascular therapySBP treatmentAdmission SBPDiabetic patientsIntensive blood pressure loweringIntensive systolic blood pressureAcute ischemic stroke trialsTarget trialsEffect of SBPBlood pressure loweringNon-diabetic patientsFavorable functional outcomeSystolic blood pressureIschemic stroke trialsSite of occlusionIntensive SBPRecanalization statusSuccessful reperfusionBlood pressure
2021
Increased Blood Pressure Variability and the Risk of Probable Dementia or Mild Cognitive Impairment: A Post Hoc Analysis of the SPRINT MIND Trial
de Havenon A, Anadani M, Prabhakaran S, Wong K, Yaghi S, Rost N. Increased Blood Pressure Variability and the Risk of Probable Dementia or Mild Cognitive Impairment: A Post Hoc Analysis of the SPRINT MIND Trial. Journal Of The American Heart Association 2021, 10: e022206. PMID: 34533059, PMCID: PMC8649507, DOI: 10.1161/jaha.121.022206.Peer-Reviewed Original ResearchConceptsBlood pressure controlBlood pressure variabilityMild cognitive impairmentCognitive impairmentProbable dementiaMIND trialBlood pressurePressure variabilityExcellent blood pressure controlPressure controlSuboptimal blood pressure controlSystolic blood pressure variabilityCox proportional hazards modelRisk of dementiaBlood pressure measurementsProportional hazards modelRate of dementiaPost Hoc AnalysisLowest tertileHighest tertilePrimary outcomeCardiovascular diseaseHoc AnalysisCox modelHazards modelBlood Pressure Management After Endovascular Thrombectomy
Peng TJ, Ortega-Gutiérrez S, de Havenon A, Petersen NH. Blood Pressure Management After Endovascular Thrombectomy. Frontiers In Neurology 2021, 12: 723461. PMID: 34539562, PMCID: PMC8446280, DOI: 10.3389/fneur.2021.723461.Peer-Reviewed Original ResearchEndovascular thrombectomyBlood pressureBP targetsAnterior circulation large vessel occlusion strokeImmediate post-stroke periodLower blood pressure targetsLarge vessel occlusion strokeAdequate BP targetsBlood pressure targetsOptimal hemodynamic managementOverall hemodynamic statusPost-stroke periodAcute stroke therapyBlood pressure managementDegree of reperfusionPotential neuroprotective strategiesIndividual patient factorsStandard of careBlood pressure optimizationNovel treatment strategiesWorse clinical recoveryBP controlKey observational studiesSuccessful reperfusionClinical recoveryMidlife Blood Pressure Variability and Risk of All-Cause Mortality and Cardiovascular Events During Extended Follow-up
de Havenon A, Delic A, Yaghi S, Wong KH, Majersik JJ, Stulberg E, Tirschwell D, Anadani M. Midlife Blood Pressure Variability and Risk of All-Cause Mortality and Cardiovascular Events During Extended Follow-up. American Journal Of Hypertension 2021, 34: 1269-1275. PMID: 34240111, PMCID: PMC8643578, DOI: 10.1093/ajh/hpab106.Peer-Reviewed Original ResearchConceptsBlood pressure variabilityLong-term blood pressure variabilityCardiovascular eventsHazard ratioPressure variabilityCardiovascular disease-free participantsMean systolic blood pressureVisit blood pressure variabilityCox proportional hazards modelCardiovascular risk factorsCorresponding hazard ratiosCongestive heart failureDisease-free patientsSystolic blood pressureDisease-free participantsProportional hazards modelPrior strokeCause mortalitySecondary outcomesBlood pressureHeart failureIndependent predictorsPrimary outcomeVisit 4Mean ageEvaluation of Systolic Blood Pressure, Use of Aspirin and Clopidogrel, and Stroke Recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial
de Havenon A, Johnston SC, Easton JD, Kim AS, Sheth KN, Lansberg M, Tirschwell D, Mistry E, Yaghi S. Evaluation of Systolic Blood Pressure, Use of Aspirin and Clopidogrel, and Stroke Recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial. JAMA Network Open 2021, 4: e2112551. PMID: 34086033, PMCID: PMC8178708, DOI: 10.1001/jamanetworkopen.2021.12551.Peer-Reviewed Original ResearchConceptsBaseline systolic blood pressureDual antiplatelet therapySystolic blood pressureTransient ischemic attackMinor Ischemic Stroke (POINT) trialNew transient ischemic attackAcute ischemic strokeIschemic strokeIschemic stroke trialsStroke recurrenceHazard ratioBlood pressurePrimary outcomeStroke trialsElevated baseline systolic blood pressureFit Cox proportional hazards modelsHigher baseline systolic blood pressureElevated systolic blood pressureCox proportional hazards modelDays of randomizationFuture stroke riskIschemic stroke recurrenceUse of aspirinSubgroup of patientsProportional hazards modelWhite Matter Hyperintensity and Cardiovascular Disease Outcomes in the SPRINT MIND Trial
Sheibani N, Wong KH, Turan TN, Yeatts SD, Gottesman RF, Prabhakaran S, Rost NS, de Havenon A. White Matter Hyperintensity and Cardiovascular Disease Outcomes in the SPRINT MIND Trial. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 105764. PMID: 33823461, PMCID: PMC8107132, DOI: 10.1016/j.jstrokecerebrovasdis.2021.105764.Peer-Reviewed Original ResearchConceptsSystolic Blood Pressure Intervention TrialWhite matter hyperintensity volumeSystolic blood pressurePrimary outcomeHazard ratioLog-transformed white matter hyperintensity volumeGoal systolic blood pressureLog-transformed continuous variableComposite of strokeIntensive BP loweringHigh cardiovascular riskAcute coronary syndromeCongestive heart failureProspective clinical trialsCardiovascular disease outcomesFuture CVD riskWhite matter hyperintensitiesSubset of participantsBP loweringCardiovascular deathCardiovascular eventsCoronary syndromeCardiovascular riskCVD riskBlood pressureAssociation of Preeclampsia With Incident Stroke in Later Life Among Women in the Framingham Heart Study
de Havenon A, Delic A, Stulberg E, Sheibani N, Stoddard G, Hanson H, Theilen L. Association of Preeclampsia With Incident Stroke in Later Life Among Women in the Framingham Heart Study. JAMA Network Open 2021, 4: e215077. PMID: 33900402, PMCID: PMC8076961, DOI: 10.1001/jamanetworkopen.2021.5077.Peer-Reviewed Original ResearchConceptsHistory of preeclampsiaVascular risk factorsIncident strokeRisk factorsFramingham Heart StudyMarginal structural modelsCohort studyStroke incidenceRelative riskHeart StudyLater lifeTime-varying covariatesMidlife vascular risk factorsPopulation-based cohort studyHigher diastolic blood pressureAbsence of preeclampsiaCholesterol-lowering medicationsDiastolic blood pressureAge 45 yearsAssociation of preeclampsiaBlood pressureMore pregnanciesStudy visitPreeclampsiaMAIN OUTCOMEBlood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke
de Havenon A, Petersen N, Sultan-Qurraie A, Alexander M, Yaghi S, Park M, Grandhi R, Mistry E. Blood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke. Seminars In Neurology 2021, 41: 046-053. PMID: 33472269, PMCID: PMC8063274, DOI: 10.1055/s-0040-1722721.Peer-Reviewed Original ResearchConceptsBlood pressure managementEndovascular thrombectomyBlood pressurePressure managementLarge vessel occlusion stroke patientsMaximum systolic blood pressureOptimal blood pressure managementAmerican Heart Association guidelinesAcute ischemic strokeHeart Association guidelinesSystolic blood pressurePenumbral perfusionSuccessful recanalizationIschemic strokeGuideline recommendationsStroke patientsHyperacute phaseAssociation guidelinesPatient outcomesClinical scenariosThrombectomyRecanalizationPatientsHgSpecific evidence
2020
Blood pressure reduction and outcome after endovascular therapy: a secondary analysis of the BEST study
Anadani M, de Havenon A, Yaghi S, Mehta T, Arora N, Starosciak AK, La Rosa F, Siegler J, Mistry AM, Chitale R, Spiotta AM, Tsivgoulis G, Khatri P, Mistry EA. Blood pressure reduction and outcome after endovascular therapy: a secondary analysis of the BEST study. Journal Of NeuroInterventional Surgery 2020, 13: 698-702. PMID: 32883780, PMCID: PMC8088286, DOI: 10.1136/neurintsurg-2020-016494.Peer-Reviewed Original ResearchConceptsSystolic blood pressure reductionSystolic blood pressureBlood pressure reductionEndovascular therapyPoor functional outcomeSuccessful recanalizationBlood pressurePoor outcomeFunctional outcomeOutcome groupAdmission systolic blood pressureOutcomes of EVTProspective observational cohort studyBaseline systolic blood pressureElevated systolic blood pressurePressure reductionHistory of hypertensionObservational cohort studyPoor outcome groupProspective multicenter cohortGood outcome groupAntihypertensive treatmentRevascularization statusCohort studyMulticenter cohortPulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis
Katsanos A, Alexandrov A, Mandava P, Köhrmann M, Soinne L, Barreto A, Sharma V, Mikulik R, Muir K, Rothlisberger T, Grotta J, Levi C, Molina C, Saqqur M, Palaiodimou L, Psaltopoulou T, Vosko M, Moreira T, Fiebach J, Rubiera M, Sandset E, de Havenon A, Kent T, Alexandrov A, Schellinger P, Tsivgoulis G, Investigators F. Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis. European Journal Of Neurology 2020, 27: 2453-2462. PMID: 32697894, DOI: 10.1111/ene.14447.Peer-Reviewed Original ResearchConceptsPatients treated with intravenous thrombolysisAcute ischaemic strokeIndependent functional outcomePulse pressure variabilityIntravenous thrombolysisIntracranial bleedingAssociated with adverse short-termFunctional outcomesBlood pressureStroke patients treated with intravenous thrombolysisTissue plasminogen activator bolusSystemic tissue plasminogen activatorAssociated with unfavorable outcomesAssociated with worse neurological outcomeSymptomatic intracranial bleedingLong-term functional outcomeSafety end pointPulse pressureAcute ischaemic stroke patientsAdverse short-termLysis of thrombiPressure variabilityTissue plasminogen activatorCombined Lysis of ThrombusIntravenous thrombolysis administration
2019
Blood pressure reduction and outcome after endovascular therapy with successful reperfusion: a multicenter study
Anadani M, Arthur AS, Alawieh A, Orabi Y, Alexandrov A, Goyal N, Psychogios MN, Maier I, Kim JT, Keyrouz SG, de Havenon A, Petersen NH, Pandhi A, Swisher CB, Inamullah O, Liman J, Kodali S, Giles JA, Allen M, Wolfe SQ, Tsivgoulis G, Cagle BA, Oravec CS, Gory B, De Marini P, Kan P, Rahman S, Richard S, Nascimento FA, Spiotta A. Blood pressure reduction and outcome after endovascular therapy with successful reperfusion: a multicenter study. Journal Of NeuroInterventional Surgery 2019, 12: 932-936. PMID: 31806668, PMCID: PMC7998040, DOI: 10.1136/neurintsurg-2019-015561.Peer-Reviewed Original ResearchConceptsSBP reductionSystolic blood pressureSuccessful reperfusionMechanical thrombectomyPoor outcomeSafety outcomesAnterior circulation large vessel occlusionElevated systolic blood pressureModified Rankin Scale scoreBlood pressure reductionComprehensive stroke centerSymptomatic intracerebral hemorrhageAcute ischemic strokeMulticenter retrospective studyRankin Scale scoreLarge vessel occlusionIncomplete reperfusionReperfusion statusSafety endpointIschemic strokeStroke centersBlood pressureComplete reperfusionEndovascular therapyIntracerebral hemorrhageBlood Pressure Variability and Cardiovascular Outcomes in Patients With Prior Stroke
de Havenon A, Fino NF, Johnson B, Wong KH, Majersik JJ, Tirschwell D, Rost N. Blood Pressure Variability and Cardiovascular Outcomes in Patients With Prior Stroke. Stroke 2019, 50: 3170-3176. PMID: 31537194, PMCID: PMC6817411, DOI: 10.1161/strokeaha.119.026293.Peer-Reviewed Original ResearchConceptsBlood pressure variabilityMajor cardiovascular eventsDiastolic blood pressure variabilityRecurrent ischemic strokeRecurrent strokeModifiable risk factorsCause deathCardiovascular eventsIschemic strokePrior strokeRisk factorsPressure variabilitySystolic blood pressure variabilitySecondary stroke preventionSystolic blood pressureAntihypertensive medicationsPRoFESS trialCardiovascular outcomesStroke preventionHazard ratioBlood pressureHigh morbidityLarge trialsCardiovascular diseasePrimary strokeBlood pressure, glycemic control, and white matter hyperintensity progression in type 2 diabetics
de Havenon A, Majersik JJ, Tirschwell DL, McNally JS, Stoddard G, Rost NS. Blood pressure, glycemic control, and white matter hyperintensity progression in type 2 diabetics. Neurology 2019, 92: e1168-e1175. PMID: 30737332, PMCID: PMC6511110, DOI: 10.1212/wnl.0000000000007093.Peer-Reviewed Original ResearchConceptsType 2 diabeticsBlood pressureWhite matter hyperintensitiesRandomization armGlycemic controlWMH progressionHigher systolic blood pressureWhite matter hyperintensity progressionIntensive blood pressureBlood pressure controlSystolic blood pressureHigh blood pressureType 2 diabetesACCORD-MINDComorbid diabetesMacrovascular complicationsCardiovascular riskHemoglobin A1cPrimary outcomeControl armMatter hyperintensitiesAggressive approachWMH volumeControl interventionsPressure controlIncreased blood pressure variability after acute ischemic stroke increases the risk of death: A secondary analysis of the Virtual International Stroke Trial Archive
de Havenon A, Stoddard G, Saini M, Wong KH, Tirschwell D, Bath P, . Increased blood pressure variability after acute ischemic stroke increases the risk of death: A secondary analysis of the Virtual International Stroke Trial Archive. JRSM Cardiovascular Disease 2019, 8: 2048004019856496. PMID: 31217966, PMCID: PMC6560789, DOI: 10.1177/2048004019856496.Peer-Reviewed Original ResearchBlood pressure variabilityVirtual International Stroke Trials ArchiveAcute ischemic strokePressure variabilityIschemic strokeStudy enrollmentAcute ischemic stroke patientsDiastolic blood pressure variabilitySystolic blood pressure variabilityIschemic stroke patientsOutcome of deathWorse neurologic outcomeDiastolic blood pressureRisk of deathBlood pressure readingsLogistic regression modelsNeurologic outcomeRankin ScaleStroke onsetBlood pressurePrimary outcomeClinical outcomesStroke patientsRetrospective analysisLarge cohort
2018
Increased Blood Pressure Variability Contributes to Worse Outcome After Intracerebral Hemorrhage
de Havenon A, Majersik JJ, Stoddard G, Wong KH, McNally JS, Smith AG, Rost NS, Tirschwell DL. Increased Blood Pressure Variability Contributes to Worse Outcome After Intracerebral Hemorrhage. Stroke 2018, 49: 1981-1984. PMID: 30012822, PMCID: PMC6202185, DOI: 10.1161/strokeaha.118.022133.Peer-Reviewed Original ResearchConceptsBlood pressure variabilitySystolic blood pressure variabilitySystolic blood pressureNeurological outcomeRankin ScaleBlood pressureAcute periodIntracerebral hemorrhageWorse outcomesPressure variabilityLong-term neurological outcomeUtility-weighted modified Rankin scaleWorse neurological outcomeAcute ischemic strokeModified Rankin ScaleBlood pressure meansATACH-2 trialProtocol-based approachATACH-2Ischemic strokeSecondary outcomesPrimary outcomeEarly identificationSecondary analysisConsistent association