Problems related to short-term antihypertensive therapy in acute ischemic stroke.
Hypertension is a common early finding after an acute ischemic stroke, even in previously normotensive patients. But its significance and proper management are a matter of debate, because of the lack of adequately powered randomized clinical trials. A close analysis of observational and interventional trials, published so far, fails to convince that an early antihypertensive therapy is needed and beneficial. During the first 24-48 hr after ischemic stroke, only blood pressure values repeatedly higher than 220/120 mmHg require antihypertensive treatment to keep blood pressure levels in the range of 180-220 mmHg systolic and 100-120 diastolic. Blood pressure reduction should be cautious with the aim of keeping the pressure at relatively high values (180/100-105 in previously hypertensive patients and 160-180/90-100 in previously normotensive patients). The usefulness of increasing blood pressure with vasopressive agents in selected patients with ischemic stroke deserves adequate testing with randomized clinical trials.
Semplicini
Andrea
A
Department of Clinical and Experimental Medicine, University of Padova Medical School, Padova, Italy. andrea.semplicini@unipd.it
Benetton
Valentina
V
Mascagna
Vania
V
Macchini
Luisa
L
Realdi
Anna
A
Sartori
Michelangelo
M
Calò
Lorenzo
L
D000208:Acute Disease; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002544:Cerebral Infarction / Q000188:drug therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents