Browse by author
Lookup NU author(s): Professor Christopher PriceORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© The Author(s) 2026. Published by Oxford University Press on behalf of the European Stroke Organisation. Introduction: Hypertension is a major modifiable risk factor for stroke. Studies between 1996 and 2013 reported high rates of non-achievement of guideline recommended blood pressure (BP) targets following stroke/TIA. Few recent large studies of long-term post-stroke BP management exist, and no studies have reported findings since the introduction of new guideline recommendations (systolic blood pressure [SBP] < 130 mmHg) in 2022. Patients and methods: We analysed BP control in the CONVINCE trial, which randomised 3154 recent ischaemic stroke/high-risk TIA patients to colchicine 0.5 mg daily or usual care. Clinic BP was measured at 6-monthly trial visits from 2017 to 2024. We calculated mean follow-up BP using all available follow-up BP measurements, and examined factors associated with non-achievement of pre-2022 guideline BP targets by multivariable logistic regression. Results: Of 3144 randomised consenting patients, at least 1 follow-up BP reading was available for 2920. There were high rates of antiplatelet medication (97.6%) and statin (94.1%) usage. Mean SBP during follow-up was 136.6 mmHg (SD 12.8), mean diastolic BP was 79.3 mmHg (SD 7.8). A total of 36% of participants had mean SBP ≥ 140 mmHg and failed to meet pre-2022 guideline targets, while 70% had mean SBP ≥ 130 mmHg, not achieving current guideline targets. On multivariable logistic regression, increased age (OR: 1.026 per year increase; 95% CI, 1.018–1.034), history of hypertension (OR: 1.47; 95% CI, 1.24–1.74) and lacunar stroke subtype (OR: 1.26; 95% CI, 1.06–1.49) were independently associated with guideline non-achievement. Discussion and Conclusion: In a large contemporary secondary stroke prevention trial, over one-third of participants did not achieve less-stringent pre-2022 BP guideline targets, and 70% did not achieve current ESO guideline targets. New approaches are needed to improve guideline implementation in practice. Trial Registration: ClinicalTrials.gov (NCT02898610).
Author(s): Synnott P, Walsh C, Weimar C, Purroy F, Price C, Fonseca AC, Hill M, Jatuzis D, Korv J, Kruuse C, Mikulik R, Nederkoorn P, Czlonkowska A, Fischer U, Nabavi DG, Harbison J, Cassidy T, O'Connor M, Iversen HK, Adie K, Lemmens R, Kelly PJ, for the CONVINCE investigators
Publication type: Article
Publication status: Published
Journal: European Stroke Journal
Year: 2026
Volume: 11
Issue: 7
Online publication date: 08/07/2026
Acceptance date: 28/04/2026
Date deposited: 20/07/2026
ISSN (print): 2396-9873
ISSN (electronic): 2396-9881
Publisher: Oxford University Press
URL: https://doi.org/10.1093/esj/aakag051
DOI: 10.1093/esj/aakag051
Data Access Statement: Data will be shared upon reasonable request for scientific analysis, in de-identified form, following completion of all planned analyses, and upon review and approval (by the CONVINCE Steering Committee) of a submitted study plan and signed data sharing agreement by the requesting investigators. Requests should be made to the senior author Prof. Peter Kelly.
Altmetrics provided by Altmetric
