Document Detail


Stroke precipitated by moderate blood pressure reduction.
MedLine Citation:
PMID:  11074327     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Rapid lowering of blood pressure can precipitate or worsen ischemic strokes. This usually has been observed in the setting of profoundly lowered pressure and hypotension. We report on six patients in whom ischemic neurologic injury ensued or worsened after moderate reduction of blood pressure by pharmacological treatment. The 6 patients suffered new or worsened ischemic neurologic deficits after receiving oral or intravenous antihypertensive medications, mostly after relatively small doses. Mean arterial blood pressure in these patients was decreased by 25 +/- 7.7%, or 37 +/- 16 mm Hg (mean +/- SD) without resultant hypotension. These cases emphasize the potential hazards of moderate blood pressure reduction by antihypertensive medications in the setting of an acute ischemic stroke or transient ischemic attack (TIA), as well as rapidly treated hypertension even in those who have not yet manifested ischemic symptoms.
Authors:
G M Fischberg; E Lozano; K Rajamani; S Ameriso; M J Fisher
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  19     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-29     Completed Date:  2000-12-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  339-46     Citation Subset:  IM    
Affiliation:
University of Southern California, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / adverse effects*
Blood Pressure / drug effects
Emergency Treatment / adverse effects,  methods
Felodipine / adverse effects
Female
Humans
Hypertension / complications*,  drug therapy*
Labetalol / adverse effects
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Middle Aged
Nifedipine / adverse effects
Patient Selection
Precipitating Factors
Stroke / chemically induced*,  diagnosis
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
NS 31945/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 21829-25-4/Nifedipine; 36894-69-6/Labetalol; 72509-76-3/Felodipine
Comments/Corrections
Comment In:
J Emerg Med. 2001 Oct;21(3):290-1   [PMID:  11604289 ]
J Emerg Med. 2000 Nov;19(4):379   [PMID:  11074336 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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