Does Blood Pressure Lowering After Thrombolysis for Acute Stroke Improve Outcomes?

A large trial showed no difference in 90-day outcomes, but blood pressure levels were not very different between standard and intensive treatment groups.

In the landmark 1995 study that demonstrated the value of thrombolysis with tissue plasminogen activator (TPA) for acute ischemic stroke, recipients had a 6.4% risk for symptomatic brain hemorrhage (N Engl J Med 1995; 333:1581). One potential approach to reducing this hemorrhage risk is active blood pressure (BP) lowering following TPA administration. In this partially manufacturer-funded, multicenter study, the authors randomized 2227 patients to standard BP treatment (systolic BP target, <180 mm Hg for the first 72 hours) or intensive BP lowering (systolic BP target, 130–140 mm Hg). The primary outcome was a shift in the modified Rankin Scale score at 90 days.

A total of 2196 patients (mean age, 67 years; 62% men) met the study criteria. M…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Does Blood Pressure Lowering After Thrombolysis for Acute Stroke Improve Outcomes?

Topics

Reviewing Author