RT Journal Article SR Electronic T1 Blood pressure reduction and outcome after endovascular therapy: a secondary analysis of the BEST study JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 698 OP 702 DO 10.1136/neurintsurg-2020-016494 VO 13 IS 8 A1 Mohammad Anadani A1 Adam de Havenon A1 Shadi Yaghi A1 Tapan Mehta A1 Niraj Arora A1 Amy Kathryn Starosciak A1 Felipe De Los Rios La Rosa A1 James Siegler A1 Akshitkumar M Mistry A1 Rohan Chitale A1 Alejandro M Spiotta A1 Georgios Tsivgoulis A1 Pooja Khatri A1 Eva A Mistry YR 2021 UL http://jnis.bmj.com/content/13/8/698.abstract AB Background Elevated systolic blood pressure (SBP) in the acute phase after endovascular therapy (EVT) is associated with worse outcome. However, the association between systolic blood pressure reduction (SBPr) and the outcome of EVT is not well understood.Objective To determine the association between SBPr and clinical outcomes after EVT in a prospective multicenter cohort.Methods A post hoc analysis of the Blood Pressure after Endovascular Stroke Therapy (BEST) prospective observational cohort study was carried out. SBPr was defined as the absolute difference between admission SBP and mean SBP in the first 24 hours after EVT. Logistic regression was used to assess the association between SBPr and poor functional outcome (modified Rankin Scale score 3–6) at 90 days.Results A total of 259/433 (58.5%) patients had poor outcome. SBPr was higher in the poor outcome group than in the good outcome group (26.6±27.4 vs 19.0±22.3 mm Hg; p<0.001). However, in adjusted models, SBPr was not independently associated with poor outcome (OR=1.00 per 1 mm Hg increase, 95% CI 0.99 to 1.01) or death (OR=0.9 per 1 mm Hg increase; 95% CI 0.98 to 1.00). No association remained when SBPr was divided into tertiles. Subgroup analyses based on history of hypertension, revascularization status, and antihypertensive treatment yielded similar results.Conclusion The reduction in baseline SBP following EVT was not associated with poor functional outcomes. Most of the cohort (88%) achieved successful recanalization, and therefore, these results mainly apply to patients with successful recanalization.Data are available upon reasonable request. Data sharing statement: Additional data from this project can be acquired by contacting the corresponding author.