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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Blood pressure management in acute ischemic stroke
Kamakshi Lakshminarayan1, David C Anderson, Catherine Borbas
1Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA. laksh004@umn.edu
Journal of Clinical Hypertension (Greenwich, Conn.)
|June 2, 2007
Summary
Managing hypertension in acute ischemic stroke patients requires improvement. Many patients were overtreated or undertreated in the first 24 hours, despite good management at discharge.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Hypertension management is critical for acute ischemic stroke patients.
- Guidelines from the American Stroke Association (ASA) and European Stroke Initiative (EUSI) exist for stroke care.
- Variability in provider practice may impact patient outcomes.
Purpose of the Study:
- To characterize provider practice in hypertension management for hospitalized acute ischemic stroke patients.
- To compare current practices against ASA and EUSI guidelines.
- To identify gaps in evidence and areas for improved patient management.
Main Methods:
- Retrospective analysis of data from the Project for Improvement of Stroke Care Management in Minnesota.
- Inclusion of 1181 hospitalized acute ischemic stroke patients.
- Assessment of hypertension treatment (as-needed medication and at discharge) against established guidelines.
Main Results:
- Among 129 patients receiving as-needed medication within 24 hours, 56% were overtreated per ASA guidelines and 24% per EUSI guidelines.
- Of 1052 patients not receiving immediate treatment, 16% were undertreated by ASA guidelines and 3% by EUSI guidelines.
- Discharge hypertension management was effective, with 93% of patients appropriately treated.
Conclusions:
- Significant overtreatment and undertreatment of hypertension occur in the acute phase of ischemic stroke.
- Current hypertension management practices in acute ischemic stroke patients do not consistently align with established guidelines.
- Further research is needed to refine guidelines and reduce practice variability for better stroke patient care.
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