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Updated: Jul 27, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
[Antihypertensive therapy in patients with stroke]
K Kanemaru1, A Kanemaru, I Kuwajima
1Department of Neurology, Tokyo Metropolitan Geriatric Hospital.
Nihon Rinsho. Japanese Journal of Clinical Medicine
|June 8, 2001
Summary
Most acute ischemic stroke patients do not require immediate blood pressure (BP) lowering. Cautious antihypertensive therapy is advised for severe hypertension or complications, with ongoing research into optimal BP for stroke recurrence prevention.
Area of Science:
- Neurology
- Cardiology
- Nephrology
Context:
- Acute ischemic stroke management guidelines.
- Cerebral autoregulation impairment in stroke patients.
- Hypertension complications and stroke outcomes.
Purpose:
- To review the current understanding of blood pressure management in acute ischemic stroke.
- To discuss the risks and benefits of antihypertensive therapy in stroke patients.
- To highlight the uncertainties in optimal blood pressure targets for secondary stroke prevention.
Summary:
- Lowering blood pressure rapidly in acute ischemic stroke is generally not recommended due to impaired cerebral autoregulation, potentially reducing cerebral blood flow.
- Antihypertensive therapy should be administered cautiously in cases of severe hypertension or when stroke is associated with complications like hemorrhagic transformation, myocardial infarction, renal failure, or aortic dissection.
- The optimal blood pressure level for preventing recurrent stroke in the chronic phase remains undetermined, with ongoing large-scale trials investigating this critical question, including the controversial J-curve phenomenon.
Impact:
- Informs clinical decision-making regarding blood pressure management in acute ischemic stroke.
- Highlights the need for individualized treatment approaches based on patient-specific factors and complications.
- Emphasizes the importance of ongoing research to establish evidence-based guidelines for secondary stroke prevention and long-term blood pressure management.
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