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Updated: Jul 15, 2026
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Real-Time Monitoring and Modulation of Blood Pressure in a Rabbit Model of Ischemic Stroke
Published on: February 10, 2023
Blood pressure management in reperfused ischemic stroke.
Lucia B Varela1,2, Camila Micaela Escobar Liquitay1, Samanta Díaz Menai1
1Research Department, Universidad Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
The Cochrane Database of Systematic Reviews
|July 14, 2026
Summary
Intensive blood pressure management after stroke reperfusion shows little benefit and may increase mortality. Further research is needed to identify patient subgroups who might benefit from lower systolic blood pressure targets.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Clinical Trials
Background:
- Stroke is a leading cause of death and disability worldwide, with ischemic strokes comprising the majority.
- Effective blood pressure management post-reperfusion therapy (thrombolysis, thrombectomy) is critical for patient outcomes.
- Current guidelines for blood pressure targets (SBP < 180 mmHg) are based on low-certainty evidence.
Purpose of the Study:
- To compare the benefits and harms of intensive systolic blood pressure (SBP) management (target < 160 mmHg) versus conventional management (target < 180 mmHg).
- To evaluate intensive SBP management in patients undergoing ischemic stroke reperfusion via thrombolysis or thrombectomy.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
- Searches included CENTRAL, MEDLINE, Embase, and trial registers, with data last updated March 20, 2025.
- Nine RCTs involving 4381 participants were included, assessing clinical function, quality of life, and adverse events.
Main Results:
- Intensive SBP management showed little to no meaningful difference in dichotomous clinical function (RR 0.89) and quality of life (SMD -0.14).
- No significant increase or decrease in any intracranial hemorrhage (ICH) was observed (RR 0.99).
- However, intensive management probably increased all-cause mortality (RR 1.19) and may reduce favorable neurologic status (RR 0.71).
Conclusions:
- Intensive SBP management (< 160 mmHg) offers limited clinical benefits and may increase all-cause mortality compared to conventional targets (< 180 mmHg).
- The certainty of evidence varies from very low to high across outcomes.
- Future research should focus on individualized blood pressure targets using subgroup analyses and diverse patient populations.
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