Association Between Prehospital Hypertension and Delays to Thrombolysis for Stroke

A retrospective study finds that prehospital BP ≥185/110 mm Hg predicts longer time to thrombolysis.

Blood pressure (BP) ≥185/110 mm Hg is a contraindication to thrombolysis for acute ischemic stroke. Investigators at a single emergency department (ED) evaluated the association between prehospital BP ≥185/110 and time to thrombolysis in a cohort of 107 patients with acute ischemic stroke and symptom onset <3 hours from ED arrival.

Of the 107 patients, 75 (70%) received thrombolysis. In a multivariable analysis, the 26 patients with prehospital BP ≥185/110 had a mean door-to-thrombolysis time of 86 minutes, versus 56 minutes for the 49 patients with prehospital BP below this threshold, a significant difference. Prehospital antihypertensive therapy was administered to 39% of the first group and 2% of the second group.

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Association Between Prehospital Hypertension and Delays to Thrombolysis for Stroke

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Reviewing Author