Blood Pressure in Acute Ischemic Stroke

Journal of Clinical Neurology
Michael McManus, David S Liebeskind

Abstract

Hypertension is present in up to 84% of patients presenting with acute stroke, and a smaller proportion of patients have blood pressures that are below typical values in the context of cerebral ischemia. Outcomes are generally worse in those who present with either low or severely elevated blood pressure. Several studies have provided valuable information about malignant trends in blood pressure during the transition from the acute to the subacute phase of stroke. It is not uncommon for practitioners in clinical practice to identify what appear to be pressure-dependent neurologic deficits. Despite physiologic and clinical data suggesting the importance of blood pressure modulation to support cerebral blood flow to ischemic tissue, randomized controlled trials have not yielded robust evidence for this in acute ischemic stroke. We highlight previous studies involving acute-stroke patients that have defined trends in blood pressure and that have evaluated the safety and efficacy of blood-pressure modulation in acute ischemic stroke. This overview reports the current status of this topic from the perspective of a stroke neurologist and provides a framework for future research.

References

Jan 1, 1977·Stroke; a Journal of Cerebral Circulation·J AstrupN A Lassen
Jun 1, 1986·Brain : a Journal of Neurology·T S OlsenR G Oberg
Nov 1, 1989·Stroke; a Journal of Cerebral Circulation·J C DrummondH M Shapiro
Sep 1, 1986·Stroke; a Journal of Cerebral Circulation·M BrittonU de Faire
Jul 1, 1997·Stroke; a Journal of Cerebral Circulation·L MorfisL G Howes
Feb 5, 1999·Stroke; a Journal of Cerebral Circulation·D W KriegerL Hantson
May 4, 2002·Stroke; a Journal of Cerebral Circulation·Jo Leonardi-BeeUNKNOWN IST Collaborative Group
Jun 21, 2003·Stroke; a Journal of Cerebral Circulation·Joachim SchraderUNKNOWN Acute Candesartan Cilexetil Therapy in Stroke Survivors Study Group
Dec 10, 2003·Hypertension·Mark WillmotPhilip M W Bath
Jan 17, 2004·Stroke; a Journal of Cerebral Circulation·José CastilloAntoni Dávalos
Jan 30, 2004·Journal of Internal Medicine·K N VemmosM Mavrikakis
Jun 1, 1989·Journal of Neurosurgical Anesthesiology·J C DrummondD J Cole
May 17, 2005·Journal of Hypertension·Koichiro OkumuraShuichi Takishita
Feb 25, 2006·Neurocritical Care·Matthew A KoenigRobert J Wityk
May 11, 2006·Journal of Hypertension·Hisatomi ArimaUNKNOWN PROGRESS Collaborative Group
Dec 13, 2006·The American Journal of Emergency Medicine·Adnan I QureshiAlluru S Reddi
Oct 27, 2007·Stroke; a Journal of Cerebral Circulation·Jin-Moo LeeWeili Lin
Dec 22, 2007·Stroke; a Journal of Cerebral Circulation·Mei Yong, Markku Kaste
Nov 21, 2009·Stroke; a Journal of Cerebral Circulation·Kenneth ButcherUNKNOWN EPITHET Investigators
Nov 19, 2013·JAMA : the Journal of the American Medical Association·Jiang HeUNKNOWN CATIS Investigators
Apr 3, 2014·Stroke; a Journal of Cerebral Circulation·Rebecca McCourtUNKNOWN ICH ADAPT Investigators
Dec 5, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Mirza JusufovicUNKNOWN Scandinavian Candesartan Acute Stroke Trial Study Group

❮ Previous
Next ❯

Citations

Aug 30, 2019·Stroke; a Journal of Cerebral Circulation·Han-Gil JeongHee-Joon Bae
Mar 19, 2020·Annals of Neurology·Mohammad AnadaniAlejandro M Spiotta
Sep 3, 2020·Journal of the American Heart Association·Nikola SladojevicJames K Liao
Dec 14, 2017·International Journal of Molecular Sciences·Mohamad El Amki, Susanne Wegener
Jun 9, 2020·Practical Neurology·Robert HurfordKeith W Muir
Feb 6, 2017·Continuum : Lifelong Learning in Neurology·Andrew M Southerland
Oct 28, 2017·Current Opinion in Neurology·Karen O AppiahThompson G Robinson
Jul 19, 2017·Frontiers in Neurology·Robert W RegenhardtThabele M Leslie-Mazwi
Jul 19, 2019·Stroke; a Journal of Cerebral Circulation·Mohammad AnadaniAlejandro M Spiotta
Jan 31, 2020·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Neel S SinghalDengke K Ma
Jan 29, 2017·Current Treatment Options in Neurology·Joshua A StoneShadi Yaghi
Sep 24, 2018·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Andrew K ConnerMichael E Sughrue
Jul 4, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Heba El-GhorouryJason P Hecht
Aug 7, 2021·Journal of the American College of Cardiology·Jose GutierrezMitchell S V Elkind

❮ Previous
Next ❯

Software Mentioned

ACCESS

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Related Papers

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
G OrlandiTuscan-Umbian Section of the Italian Society of Neurology
© 2021 Meta ULC. All rights reserved