Effect of vasoactive therapy on cerebral circulation
Denise H Rhoney1, Xi Liu-DeRyke
1Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, USA.
Insights
Managing blood pressure after acute stroke is debated. This review examines cerebrophysiology and evidence for or against acute hypertension treatment within 24 hours, offering recommendations.
Area of Science:
- Neurology
- Cardiology
- Critical Care Medicine
Background:
- Uncertainty persists regarding optimal blood pressure management following acute stroke.
- The debate centers on the necessity and intensity of acute hypertension treatment in stroke patients.
Purpose of the Study:
- To review normal and altered cerebrophysiology in the context of acute stroke.
- To present evidence supporting and opposing active blood pressure management within the first 24 hours post-stroke.
- To evaluate intravenous antihypertensive agents and their cerebrovascular effects.
Main Methods:
- Literature review of cerebrophysiology.
- Analysis of evidence regarding acute blood pressure management in stroke.
- Review of intravenous antihypertensive agents and their effects.
Main Results:
- Evidence for and against active blood pressure lowering in the acute phase of stroke is presented.
- Cerebrovascular effects of commonly used intravenous antihypertensive agents are discussed.
Conclusions:
- Therapeutic recommendations for blood pressure management in acute stroke are provided based on current evidence.
- Highlights the need for further research to resolve ongoing debates in post-stroke hypertension management.
Abstract:
Many questions regarding blood pressure management after acute stroke remain unanswered, resulting in an ongoing debate about whether to treat hypertension acutely and how aggressively blood pressure should be lowered. This review discusses normal and altered cerebrophysiology and provides evidence supporting and opposing the active management of blood pressure within the first 24 hours after stroke. Commonly used intravenous antihypertensive agents and their cerebrovascular effects are reviewed, and therapeutic recommendations are given based on the available evidence.
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