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Comment & Response
June 11, 2014

Antihypertensive Therapy After Acute Ischemic Stroke—Reply

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

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.