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Comment & Response |

Antihypertensive Therapy After Acute Ischemic Stroke—Reply

Jiang He, MD, PhD1; Yonghong Zhang, MD, PhD2; Jing Chen, MD, MSc3
[+] Author Affiliations
1Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
2School of Public Health, Medical College of Soochow University, Suzhou, China
3Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
JAMA. 2014;311(22):2334-2335. doi:10.1001/jama.2014.5167.
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In Reply Dr Nikolaidou and colleagues correctly pointed out that a 27% reduction in the composite outcome of death and major disability was identified (odds ratio, 0.73 [95% CI, 0.55-0.97], P = .03) at the 3-month posttreatment follow-up among patients who received antihypertensive treatment 24 hours or longer after stroke onset.

The P value for homogeneity (interaction test) among 3 subgroups by time from stroke symptom onset to antihypertensive treatment (<12, 12-23, and ≥24 hours) was .03 (presented in Figure 4 of our article). We agree that the finding from a subgroup analysis can only be used to generate a study hypothesis, which will be tested in future randomized clinical trials.


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June 11, 2014
Barbara Nikolaidou, MD; Antonios Lazaridis, MD; Michael Doumas, MD, PhD
1Aristotle University of Thessaloniki, Thessaloniki, Greece
2George Washington University, Washington, DC
JAMA. 2014;311(22):2333-2334. doi:10.1001/jama.2014.5161.
June 11, 2014
Simone Vidale, MD; Claudio Pini, MD; Marco Arnaboldi, MD
1Department of Neurology and Stroke Unit, Sant’Anna Hospital, Como, Italy
JAMA. 2014;311(22):2334. doi:10.1001/jama.2014.5164.
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