Blood pressure management in acute stroke

Blood pressure (BP) is elevated in 75% or more of patients with acute stroke and is associated with poor outcomes. Whether to modulate BP in acute stroke has long been debated. With the loss of normal cerebral autoregulation, theoretical concerns are twofold: high BP can lead to cerebral oedema, hae...

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Main Authors: Appleton, Jason P., Sprigg, Nikola, Bath, Philip M.W.
Format: Article
Published: BMJ 2016
Online Access:https://eprints.nottingham.ac.uk/34068/
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author Appleton, Jason P.
Sprigg, Nikola
Bath, Philip M.W.
author_facet Appleton, Jason P.
Sprigg, Nikola
Bath, Philip M.W.
author_sort Appleton, Jason P.
building Nottingham Research Data Repository
collection Online Access
description Blood pressure (BP) is elevated in 75% or more of patients with acute stroke and is associated with poor outcomes. Whether to modulate BP in acute stroke has long been debated. With the loss of normal cerebral autoregulation, theoretical concerns are twofold: high BP can lead to cerebral oedema, haematoma expansion or haemorrhagic transformation; and low BP can lead to increased cerebral infarction or perihaematomal ischaemia. Published evidence from multiple large, high-quality, randomised trials is increasing our understanding of this challenging area, such that BP lowering is recommended in acute intracerebral haemorrhage and is safe in ischaemic stroke. Here we review the evidence for BP modulation in acute stroke, discuss the issues raised and look to on-going and future research to identify patient subgroups who are most likely to benefit.
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spelling nottingham-340682020-05-04T17:55:20Z https://eprints.nottingham.ac.uk/34068/ Blood pressure management in acute stroke Appleton, Jason P. Sprigg, Nikola Bath, Philip M.W. Blood pressure (BP) is elevated in 75% or more of patients with acute stroke and is associated with poor outcomes. Whether to modulate BP in acute stroke has long been debated. With the loss of normal cerebral autoregulation, theoretical concerns are twofold: high BP can lead to cerebral oedema, haematoma expansion or haemorrhagic transformation; and low BP can lead to increased cerebral infarction or perihaematomal ischaemia. Published evidence from multiple large, high-quality, randomised trials is increasing our understanding of this challenging area, such that BP lowering is recommended in acute intracerebral haemorrhage and is safe in ischaemic stroke. Here we review the evidence for BP modulation in acute stroke, discuss the issues raised and look to on-going and future research to identify patient subgroups who are most likely to benefit. BMJ 2016-06-24 Article PeerReviewed Appleton, Jason P., Sprigg, Nikola and Bath, Philip M.W. (2016) Blood pressure management in acute stroke. Stroke and Vascular Neurology, 1 (2). pp. 72-82. ISSN 2059-8696 http://svn.bmj.com/content/1/2/72 doi:10.1136/svn-2016-000020 doi:10.1136/svn-2016-000020
spellingShingle Appleton, Jason P.
Sprigg, Nikola
Bath, Philip M.W.
Blood pressure management in acute stroke
title Blood pressure management in acute stroke
title_full Blood pressure management in acute stroke
title_fullStr Blood pressure management in acute stroke
title_full_unstemmed Blood pressure management in acute stroke
title_short Blood pressure management in acute stroke
title_sort blood pressure management in acute stroke
url https://eprints.nottingham.ac.uk/34068/
https://eprints.nottingham.ac.uk/34068/
https://eprints.nottingham.ac.uk/34068/