COMMIT
(2025)Objective
To evaluate safety and effectiveness of early intensive BP treatment with remote telemetric home BP monitoring (RT-HBPM) after TIA/minor stroke
Study Summary
• Intensive BP control with RT-HBPM reduced disabling/fatal stroke by 44% (aHR 0.56)
• 5-year ischemic stroke and ICH both significantly reduced
• BP at 1 month: 127/72 mmHg with RT-HBPM vs 137/75 mmHg standard care
• 5-year ischemic stroke and ICH both significantly reduced
• BP at 1 month: 127/72 mmHg with RT-HBPM vs 137/75 mmHg standard care
Intervention
RT-HBPM with daily physician review targeting BP <130/80 mmHg + antiplatelet vs Standard prescription-based care + antiplatelet
Inclusion Criteria
TIA or minor stroke patients referred to Oxvasc Clinical Service, Oxfordshire, UK
Study Design
Arms: Policy-3 (2008–2020): RT-HBPM intensive monitoring vs Policy-2 (2004–2008): Standard care
Outcome
• BP at 1 month: 127/72 vs 137/75 mmHg (p<0.0001)
• Disabling/fatal stroke: aHR 0.56 (95% CI 0.33–0.95)
• 5-year ischemic stroke: aHR 0.62 (95% CI 0.50–0.77)
• 5-year ICH: aHR 0.48 (95% CI 0.25–0.91)
• mRS ordinal shift: p=0.015
• Disabling/fatal stroke: aHR 0.56 (95% CI 0.33–0.95)
• 5-year ischemic stroke: aHR 0.62 (95% CI 0.50–0.77)
• 5-year ICH: aHR 0.48 (95% CI 0.25–0.91)
• mRS ordinal shift: p=0.015