年會貴賓演講

Plenary Lecture
BP Targets in Secondary Stroke Prevention: Does One Size
Fit All?
Bruce Ovbiagele, MD, MSc, MAS, MBA
Associate Dean of the San Francisco VA Healthcare System
Professor of Neurology, University of California, San Francisco
Chief of Medical Officer, San Francisco Veteran Affairs Health Care
System

Dr. Ovbiagele earned his MD from the University of Lagos, Master of Science in Clinical Research
(MSc) from UCLA, Master of Advanced Studies (MAS) from UCSD, MBA from the University
of Massachusetts, Amherst, and an Executive Certificate in Public Leadership from the John F.
Kennedy School of Government at Harvard University. Dr. Ovbiagele maintains several National
Insititutes of Health funded research programs, focused on improving outcomes for those with,
or at risk for stroke, including the largest study of stroke in Sub-Saharan Africa, to-date. In 2008,
his work was recognized by the American Academy of Neurology with the Michael Pessin Stroke
Research Leadership Award. Dr. Ovbiagele is an elected fellow of the Royal College of Physicians
(London), American Academy of Neurology, American Neurological Association, American Heart
Association Stroke Council, American Association of Physician Leadership, and European Stroke
Organization, as well as an AAMC Council of Deans Fellow. He is also the immediate past chair of
the International Stroke Conference, the premier scientific stroke conference in the world, and is a
National Spokesperson for the American Stroke Association, interpreting the latest stroke science
for medical professionals and the lay public.

Abstract
While the underlying pathophysiological rationale and clinical trial evidence for lowering
blood pressure (BP) in people with hypertension to safely and effectively prevent a primary
stroke of any type are overwhelmingly clear, there remain unresolved questions with regard
to secondary stroke prevention - what to do, when to do it, with whom to do it, and how
aggressively to do it? Concerning the last question, a relative lack of clarity persists due to
theoretical efficacy /safety concerns about type of stroke, and timing after stroke, as well as a
relative paucity of published BP target secondary stroke prevention treatment trials, especially
aims at systolic BP targets < 120 mmHg. This presentation will provide an overview of
prevailing published evidence from limited clinical trial data, observational studies, and meta-
analyses; review current expert consensus guideline recommendations; examination emerging
insights from recently published and soon-to-be published studies; and finally convey the
notion that at this time a differential approach to BP Targets in Secondary Stroke Prevention
may be required for certain stroke patient populations.

212