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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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Management of Acute Hypertensive Response in Patients With Ischemic Stroke

Ahmad AlSibai1, Adnan I Qureshi2

  • 1Saint Francis Hospital, Greenville, SC, USA.

The Neurohospitalist
|July 2, 2016
PubMed

Insights

Aggressively lowering high blood pressure (BP) in acute ischemic stroke patients is not recommended due to potential harm and lack of evidence. Current data suggests caution in managing BP during the initial 72 hours post-stroke.

Area of Science:

  • Neurology
  • Cardiology
  • Clinical Trials

Background:

  • High blood pressure (BP) is prevalent in acute stroke patients and linked to poor outcomes.
  • Managing acute hypertension in ischemic stroke is debated, with guidelines calling for more research.
  • Chronic hypertension management is crucial for stroke prevention, but acute phase treatment remains unclear.

Purpose of the Study:

  • To review current data on managing elevated blood pressure in the first 72 hours after acute ischemic stroke.
  • To evaluate the evidence for and against antihypertensive therapy in the acute phase of stroke.
  • To inform clinical practice regarding acute hypertensive response in stroke patients.

Main Methods:

  • Systematic review of existing clinical trial data and guidelines.
  • Analysis of studies investigating the effects of blood pressure reduction in acute ischemic stroke.
  • Evaluation of the association between blood pressure management and functional outcomes.

Main Results:

  • Some clinical trials suggest potential deleterious effects of aggressive BP lowering in acute ischemic stroke.
  • There is a lack of convincing evidence to support routine acute blood pressure reduction in this population.
  • Angiotensin receptor antagonists may offer cardiovascular benefits, independent of BP reduction.

Conclusions:

  • Aggressive blood pressure reduction is currently not recommended for patients with acute ischemic stroke.
  • Further clinical trials are needed to clarify the role of antihypertensive therapy in the acute stroke phase.
  • The benefits of certain medications like ARBs may extend beyond blood pressure lowering.

Keywords:
braincerebrovascular disordershypoxia-ischemiaischemic attackstroketransient

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