Should We Lower Blood Pressure in Acute Ischemic Stroke?

In a randomized trial, outcomes were neither better nor worse with early antihypertensive therapy.

A 2013 guideline from the American Stroke Association recommends that we avoid antihypertensive drug therapy during the first 24 hours after onset of acute ischemic stroke unless systolic or diastolic blood pressure (BP) exceeds 220 mm Hg or 120 mm Hg, respectively. (The threshold is 185/110 mm Hg for patients receiving thrombolytic therapy; Stroke 2013; 44:870) The concern is that early BP lowering might worsen stroke outcomes. However, no large randomized trials have tested this theory, until now.

Researchers in China randomized 4700 patients with acute ischemic stroke to receive antihypertensive therapy (target BP, 140/90 mm Hg) or no antihypertensive therapy, initiated within 24 hours. Patients were excluded if BP was >220/120 mm Hg, thr…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Should We Lower Blood Pressure in Acute Ischemic Stroke?

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Reviewing Author