Stroke; a journal of cerebral circulation
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Comparative Study
Medium-term variability of blood pressure and potential underdiagnosis of hypertension in patients with previous transient ischemic attack or minor stroke.
Blood pressure (BP) is a major risk factor for stroke. However, the variability of systolic and diastolic BP (SBP and DBP) means that single measurements do not provide a reliable measure of usual BP. Although 24-hour ambulatory BP monitoring can correct for the effects of short-term variation, there is also important medium-term variability. The extent of medium-term variability in BP is most marked in patients with a previous transient ischemic attack (TIA) or stroke. We studied the potential impact of this variability on the likely recognition of hypertension. ⋯ Given the greater medium-term variability of BP in patients with a previous TIA or stroke than in the general population, single measurements of "normal" or "low" BP will substantially underestimate the true prevalence of hypertension.
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Meta Analysis Comparative Study
Off-pump surgery is associated with reduced occurrence of stroke and other morbidity as compared with traditional coronary artery bypass grafting: a meta-analysis of systematically reviewed trials.
There is growing enthusiasm for coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB). Although deleterious effects of CPB are known, it remains to be proven that avoiding CPB will result in reduction in morbidity. We sought to determine whether off-pump surgery is associated with reduced occurrence of adverse outcomes as compared with CABG with CPB. ⋯ Off-pump CABG is associated with reduced risk of stroke, AF and infections as compared with CABG with CPB. Evidence should be generalized taking into account RCT enrollment limitations, drawbacks related to training requirements, propensity to perform fewer grafts and likely reinterventions after off-pump surgery.