Blood pressure management in acute stroke.pdf (178.93 kB)
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Managing high blood pressure during acute ischemic stroke and intracerebral hemorrhage.

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journal contribution
posted on 26.02.2018, 14:31 by Karen O. Appiah, Jatinder S. Minhas, Thompson G. Robinson
PURPOSE OF REVIEW: Blood pressure (BP) elevations above premorbid levels are observed in at least 60% of acute ischemic and hemorrhagic stroke patients, within the first 24 h of symptom onset. A number of potential causes have been hypothesized, and high BP may be associated with poor stroke outcome. This review discusses management strategies of high BP in acute stroke, in the context of current guidelines. RECENT FINDINGS: Excessive BP elevation can impact acute stroke therapeutic strategies, particularly in modifying intervention safety and efficacy. Currently, guidance on BP management in acute ischemic stroke and intracerebral hemorrhage (ICH) exists in a limited number of specific clinical presentations, including spontaneous ICH and continuing versus stopping preexisting antihypertensive therapy. However, ongoing clinical trials will further investigate the safety and efficacy of urgent BP-lowering therapy for other indications. SUMMARY: There are clear national and international guidelines on BP lowering for specific indications, as well as ongoing clinical trials aiming to address common clinical scenarios in which the evidence-base is lacking and uncertain. This is specifically in important stroke subgroups previously excluded from trials, patients requiring mechanical thrombectomy and nonvitamin K antagonist-associated ICH reversal.

History

Citation

Current Opinion in Neurology, 2018, 31(1), pp. 8–13

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

Current Opinion in Neurology

Publisher

Lippincott, Williams & Wilkins

issn

1350-7540

eissn

1473-6551

Copyright date

2017

Available date

01/03/2019

Publisher version

https://journals.lww.com/co-neurology/Abstract/2018/02000/Managing_high_blood_pressure_during_acute_ischemic.3.aspx

Notes

The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

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