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Blood pressure management in stroke.
MedLine Citation:
PMID:  22895120     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Cerebrovascular disease is a common cause of death and disability worldwide. The current literature supports an association between blood pressure (BP) and patient outcome during acute stroke. This review will provide an overview of the evidence to guide BP management during acute stroke. RECENT FINDINGS: Hypotension and hypertension are correlated with poor outcome in acute ischemic stroke, but the effect of reducing or augmenting BP is unclear. In most cases, BP should be treated only when SBP is greater than 220 or greater than 180 in candidates for thrombolysis. There is a lack of evidence to support the choice of specific agents. Use of vasopressor drugs to treat hypotension in acute stroke should be limited to selective situations. In acute hemorrhagic stroke, SBP greater than 140 has been correlated with poor outcomes. Two recent studies report the safety and feasibility of early BP reduction in hemorrhagic stroke. SUMMARY: Both hypertension and hypotension are associated with worse outcomes during acute stroke; however, the optimal hemodynamic parameters are not clearly defined in this patient population. Despite active research, there is a lack of high-quality data guiding current BP management in stroke. Several trials currently underway may clarify the many existing questions on this topic.
Authors:
Anne L Donovan; Alana M Flexman; Adrian W Gelb
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-14
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  -     ISSN:  1473-6500     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA bDepartment of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver General Hospital, J Pattison Pavilion North, Vancouver, British Columbia, Canada.
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