[Management of blood pressure in acute ischemic stroke: a meta-analysis]

Objective: We are aiming at conducting a meta-analysis of the literature to elucidate the efficacy and safety of anti-hypertension therapy in acute stage of ischemic stroke (AIS). Methods: Researches on the efficacy and safety of anti-hypertension therapy published on PubMed before 1st September 2017 were independently retrieved by two authors.Clinical benign prognosis and death measured as modified Rankin Scale (mRS) ≤2 and mRS=6 were taken as primary indicators of efficacy and safety, respectively.A meta-analysis of included randomized controlled trials (RCTs) was performed by RevMan 5.3 software, with funnel plot evaluating the publication bias.A systemic literature review was also made to illustrate the management of blood pressure in AIS. Results: Altogether 13 papers were included in the meta-analysis, among which 12 researches (including 7 596 versus 7 503 cases in the treatment and control group, respectively) based meta-analysis showed that anti-hypertensive therapy initiated within 72 h in AIS did not increase the rate of clinical benign prognosis (OR=1.01, 95%CI 0.94-1.08, P=0.79), and 11 studies (including 7 503 versus 7 369 cases in the treatment and control group, respectively) based analysis suggested there was no significant difference in mortality between the two groups (OR=1.03, 95%CI 0.92-1.15, P=0.59). No significant publication bias for the included studies was showed in the funnel plots. Conclusions: Despite a relative safe profile of anti-hypertensive therapy for AIS, the overall therapeutic efficacy was not improved.The efficacy of anti-hypertensive therapy may be associated with the status of recanalization of blood vessels, further researches are needed to validate the efficacy of anti-hypertension therapy in certain subgroups of IS.