In 816 people after stroke thrombectomy, intensive blood-pressure lowering lined up with worse 90-day scores in men, and not in women

What the research found

Neurology published an exploratory secondary analysis on 9 November 2026. Renjun Gu, Xuan Zhu, and colleagues reanalyzed ENCHANTED2/MT, an open-label trial with blinded end-point review at 44 hospitals in China. Adults had a large-vessel stroke, successful reperfusion, and systolic blood pressure that stayed high within 3 hours. The sample was 816 people, mean age 67.6 years (standard deviation 12.0), 38 percent women. In men, intensive lowering was tied to a worse 90-day modified Rankin scale (adjusted common odds ratio 1.91; 95 percent CI 1.29 to 2.83). In women the estimate was 0.94 (0.56 to 1.57). The ratio of those odds ratios was 0.49 (0.26 to 0.94). Each 5 mm Hg higher mean systolic pressure was tied to a worse score in men (adjusted common odds ratio 1.11; 95 percent CI 1.03 to 1.20) and not in women (0.95; 0.85 to 1.05; ratio 0.85; 0.75 to 0.97). Variability in systolic pressure showed a weaker sex split. The authors say this should be tested on purpose before anyone uses it to set a different target for women and men. NCT04140110. DOI 10.1212/WNL.0000000000218703. Not medical advice.

Evidence level: Human study. A study in people, but an association isn't proof of cause.

Read the original at Neurology