Objective To explore the impact of early blood pressure reduction on the prognosis of acute ischemic stroke. Methods We searched PubMed, Embase, Cochrane Library, Wanfang, China National Knowledge Infrastructure, and Chongqing VIP, with the search period from databases establishment to December 31, 2024. Randomized controlled studies on early blood pressure reduction within 7 days after the onset of acute ischemic stroke were included, and meta-analysis was conducted using RevMan 5.4 software. Results Finally, 15 randomized controlled studies were included. The meta-analysis results showed that there was no statistically significant difference in the primary outcome (90 days disability or death) and the secondary outcomes (90 days all-cause death) between the early blood pressure reduction group and the control group (P>0.05). Compared with the control group, the early blood pressure reduction group had a higher National Institute of Health Stroke Scale score at 2 weeks [standardized mean difference=0.25, 95% confidence interval (0.07, 0.44), P=0.008]. Conclusion Early blood pressure reduction cannot reduce the risk of 90 days disability or death and 90 days all-cause death in patients with acute ischemic stroke, and may be detrimental to 2 weeks neurological function recovery.
Objective To explore the association between different levels of physical activity and the risk of stroke in middle-aged and elderly people. Methods Middle-aged and elderly people from the China Health and Retirement Longitudinal Study in 2020 were selected as the research subjects. According to total physical (TPA) activity levels, the groups were divided into the inactive group, the low TPA group, the medium TPA group, and the high TPA group. This study used a logistic regression model to explore the impact of different levels of physical activity on the risk of stroke in middle-aged and elderly people. Results A total of 16 027 middle-aged and elderly population were included. Among them, 14 557 were physically active and 1 470 were inactive. Among the 14 557 physically active subjects, there were 4 852 in the high TPA group, 4 852 in the medium TPA group, and 4 853 in the low TPA group. 1 096 (6.8%) middle-aged and elderly people suffered from stroke. The research results showed that after correcting for covariates, medium and high TPA were significantly associated with a lower risk of stroke in middle-aged and elderly people (P<0.01). Furthermore, this study found a nonlinear relationship between TPA level and the prevalence of stroke (P for nonlinear=0.042). Conclusion Medium and high TPA levels are associated with a lower risk of stroke in middle-aged and elderly populations.