Stroke and hypertension. Antihypertensive therapy withdrawal

Area of Science:

• Neurology
• Cardiology
• Clinical Pharmacology

Background:

• Hypertension is a common comorbidity in acute ischemic stroke.
• The optimal management of blood pressure and antihypertensive therapy during acute ischemic stroke remains a subject of investigation.
• Understanding the impact of antihypertensive therapy withdrawal is crucial for patient care.

Purpose of the Study:

• To assess the effect of withdrawing antihypertensive therapy in acute ischemic stroke patients.
• To explore correlations between blood pressure values and modified Rankin Scale (mRS) outcomes after therapy withdrawal.
• To evaluate the combined effect of antihypertensive and anticoagulant therapy.

Main Methods:

• A cohort of 112 consecutive acute ischemic stroke patients with hypertension was studied.
• Antihypertensive therapy was discontinued in 59 patients, while others continued treatment.
• Clinical outcomes, mortality, and mRS scores were compared between groups.

Main Results:

• No statistically significant differences in clinical outcome or mortality were found between patients with and without antihypertensive therapy withdrawal.
• Positive correlations were observed between mRS outcome and decreased systolic/diastolic blood pressure in patients on combined therapy.
• Negative correlations between mRS outcome and low diastolic blood pressure were noted in patients who discontinued antihypertensive therapy.

Conclusions:

• Withdrawing antihypertensive therapy in acute ischemic stroke patients did not significantly impact outcomes.
• Low diastolic blood pressure following antihypertensive therapy withdrawal is associated with poor outcomes.
• Combined antihypertensive and anticoagulant therapy is emphasized for acute ischemic stroke patients with hypertension.