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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Long-Term Secondary Prevention: Management of Blood Pressure After a Transient Ischemic Attack or Stroke

Iain J McGurgan1, Peter J Kelly2, Tanya N Turan3

  • 1Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (I.J.M., P.M.R.).

Stroke
|March 16, 2022
PubMed

Insights

Lowering blood pressure (BP) significantly prevents strokes. This review examines optimal BP management after stroke or transient ischemic attack to reduce recurrent vascular events and improve patient outcomes.

Area of Science:

  • Neurology
  • Cardiology
  • Public Health

Background:

  • Reducing blood pressure (BP) is crucial for stroke prevention.
  • Evidence supports antihypertensive therapy for primary stroke prevention.
  • Uncertainty exists regarding optimal BP management post-stroke for secondary prevention.

Purpose of the Study:

  • To review evidence on BP control after stroke or transient ischemic attack (TIA).
  • To address key questions in secondary stroke prevention regarding BP management.
  • To highlight recent developments for improving post-stroke BP control.

Main Methods:

  • Systematic review of randomized trials and clinical evidence.
  • Analysis of data on BP lowering strategies after cerebrovascular events.
  • Evaluation of factors influencing recurrent stroke and vascular events.

Main Results:

  • Antihypertensive therapy reduces stroke risk in primary prevention.
  • Significant risks of recurrent stroke, coronary events, and vascular death persist post-stroke.
  • Key questions remain regarding treatment initiation, intensity, drug choice, and long-term monitoring.

Conclusions:

  • Optimizing BP control after stroke is critical for secondary prevention.
  • Further research and clinical guidelines are needed for effective post-stroke BP management.
  • Emerging strategies offer potential improvements in managing BP in stroke survivors.

Keywords:
blood pressureischemic attack, transientsecondary preventionstroke

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