Document Detail

Blood pressure control in acute cerebrovascular disease.
MedLine Citation:
PMID:  21366852     Owner:  NLM     Status:  In-Data-Review    
Acute cerebrovascular diseases (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage) affect 780,000 Americans each year. Physicians who care for patients with these conditions must be able to recognize when acute hypertension requires treatment and should understand the principles of cerebral autoregulation and perfusion. Physicians should also be familiar with the various pharmacologic agents used in the treatment of cerebrovascular emergencies. Acute ischemic stroke frequently presents with hypertension, but the systemic blood pressure should not be treated unless the systolic pressure exceeds 220 mm Hg or the diastolic pressure exceeds 120 mm Hg. Overly aggressive treatment of hypertension can compromise collateral perfusion of the ischemic penumbra. Hypertension associated with intracerebral hemorrhage can be treated more aggressively to minimize hematoma expansion during the first 3 to 6 hours of illness. Subarachnoid hemorrhage is usually due to aneurysmal rupture; systolic blood pressure should be kept <150 mm Hg to prevent rerupture of the aneurysm. Nicardipine and labetalol are recommended for rapidly treating hypertension during cerebrovascular emergencies. Sodium nitroprusside is not recommended due to its adverse effects on cerebral autoregulation and intracranial pressure. Hypoperfusion of the injured brain should be avoided at all costs. J Clin Hypertens (Greenwich). 2011;13:205-211. © 2010 Wiley Periodicals, Inc.
William B Owens
Publication Detail:
Type:  Journal Article     Date:  2010-12-10
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  13     ISSN:  1751-7176     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  205-11     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
From the Division of Pulmonary and Critical Care Medicine, University of South Carolina School of Medicine, Columbia, SC.
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