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Blood pressure management in stroke

Anne L Donovan1, Alana M Flexman, Adrian W Gelb

  • 1Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California 94143-0648, USA.

Current Opinion in Anaesthesiology
|August 17, 2012
PubMed

Insights

Managing blood pressure (BP) in acute stroke is complex. While both high and low BP impact outcomes, specific treatment guidelines remain unclear, necessitating further research.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Critical Care

Background:

  • Cerebrovascular disease is a leading cause of death and disability globally.
  • Blood pressure (BP) levels significantly influence patient outcomes in acute stroke.
  • Current evidence suggests a link between BP and stroke prognosis, but management strategies require clarification.

Purpose of the Study:

  • To review existing evidence on blood pressure management during acute stroke.
  • To provide guidance for clinicians on optimizing BP in stroke patients.
  • To highlight areas where further research is needed.

Main Methods:

  • Systematic review of current literature on BP management in acute stroke.
  • Analysis of studies examining the effects of hypotension and hypertension on stroke outcomes.
  • Evaluation of treatment recommendations for BP in ischemic and hemorrhagic stroke.

Main Results:

  • Both hypotension and hypertension are associated with poorer outcomes in acute ischemic stroke.
  • BP treatment is generally recommended only for systolic BP >220 mmHg or >180 mmHg in thrombolysis candidates.
  • In acute hemorrhagic stroke, systolic BP >140 mmHg correlates with adverse outcomes; early BP reduction shows promise.

Conclusions:

  • Optimal hemodynamic targets in acute stroke remain undefined.
  • High-quality data to guide BP management in stroke is limited.
  • Ongoing clinical trials are expected to provide clearer guidelines for BP management in stroke.
Abstract

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