Document Detail

The management of blood pressure after stroke.
MedLine Citation:
PMID:  17622908     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Control of hypertension is a well-established goal of primary prevention of stroke, but management of blood pressure in patients with a previous stroke or in the setting of acute stroke is complicated by the effect blood pressure changes may have on cerebral perfusion. REVIEW SUMMARY: For patients with previous transient ischemic attack or chronic stroke, blood pressure reduction appears to be a safe and important facet of the secondary prevention of recurrent stroke. Less information is available concerning blood pressure management in acute stroke. Current protocols require strict blood pressure control in patients who are treated with thrombolytic therapy, to reduce the risk of hemorrhagic complications. In patients presenting with acute intracerebral hemorrhage, blood pressure reduction does not appear to cause significant reduction of cerebral blood flow, but at this time there are no studies to determine if there is a clinical benefit of acute blood pressure reduction in these patients. Finally, blood pressure reduction is not routinely recommended in patients with acute ischemic stroke, as it may precipitate further cerebral ischemia. Preliminary studies suggest, in fact, that there may be a role in the future for blood pressure elevation in the treatment of patients with acute ischemic stroke. CONCLUSIONS: Current data support the use of blood pressure reduction in the secondary prevention of stroke in patients with cerebrovascular disease. In the setting of acute stroke, however, data are limited and blood pressure management must be tailored to the specific clinical situation.
Robert J Wityk
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The neurologist     Volume:  13     ISSN:  1074-7931     ISO Abbreviation:  Neurologist     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-11     Completed Date:  2007-09-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9503763     Medline TA:  Neurologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  171-81     Citation Subset:  IM    
From the Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
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MeSH Terms
Blood Pressure / physiology*
Recurrence / prevention & control
Stroke / pathology,  physiopathology*,  prevention & control

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

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