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Management of blood pressure in stroke

OBJECTIVE: In this review and opinion piece, we discuss recent United States (US)-based guidance statements on the management of BP in stroke according to stroke type and stage of stroke. METHODS: We reviewed the most recent guidance statements on BP control from United States (US)-based organizatio...

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Autores principales: Gorelick, Philip B., Qureshi, Shakaib, Farooq, Muhammad U.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803067/
https://www.ncbi.nlm.nih.gov/pubmed/33447751
http://dx.doi.org/10.1016/j.ijchy.2019.100021
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author Gorelick, Philip B.
Qureshi, Shakaib
Farooq, Muhammad U.
author_facet Gorelick, Philip B.
Qureshi, Shakaib
Farooq, Muhammad U.
author_sort Gorelick, Philip B.
collection PubMed
description OBJECTIVE: In this review and opinion piece, we discuss recent United States (US)-based guidance statements on the management of BP in stroke according to stroke type and stage of stroke. METHODS: We reviewed the most recent guidance statements on BP control from United States (US)-based organizations such as the American Heart Association/American Stroke Association (AHA/ASA) and American College of Cardiology (ACC), and articles available to the authors in their personal files. RESULTS: The key BP target before starting alteplase (t-PA) is < 185/110 mm Hg, and the maintenance BP after tPA administration is < 180/105 mm Hg. For IPH patients with systolic BP between 150 and 220 mm Hg and no contraindication to acute BP reduction therapy, acute lowering to 140 mm Hg systolic BP is safe. For persons with small vessel or lacunar cerebral ischemia, a reasonable BP lowering target is < 130 mm Hg systolic. For primary stroke prevention, the target BP for those with hypertension is < 140/90 mm Hg and self-measured BP is recommended to assist in BP control. Recent study and guidance suggest a BP target of <130/80 mm Hg for both primary and recurrent stroke prevention. BP control is reasonable for the prevention of cognitive decline or dementia. CONCLUSIONS: BP targets for the proper management of stroke vary by chronological stage of stroke and by stroke subtype. Furthermore, consideration should be given to control of BP variability, especially in the acute phases of stroke, as it may play a role in conferring longer term outcomes.
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spelling pubmed-78030672021-01-13 Management of blood pressure in stroke Gorelick, Philip B. Qureshi, Shakaib Farooq, Muhammad U. Int J Cardiol Hypertens Review Article OBJECTIVE: In this review and opinion piece, we discuss recent United States (US)-based guidance statements on the management of BP in stroke according to stroke type and stage of stroke. METHODS: We reviewed the most recent guidance statements on BP control from United States (US)-based organizations such as the American Heart Association/American Stroke Association (AHA/ASA) and American College of Cardiology (ACC), and articles available to the authors in their personal files. RESULTS: The key BP target before starting alteplase (t-PA) is < 185/110 mm Hg, and the maintenance BP after tPA administration is < 180/105 mm Hg. For IPH patients with systolic BP between 150 and 220 mm Hg and no contraindication to acute BP reduction therapy, acute lowering to 140 mm Hg systolic BP is safe. For persons with small vessel or lacunar cerebral ischemia, a reasonable BP lowering target is < 130 mm Hg systolic. For primary stroke prevention, the target BP for those with hypertension is < 140/90 mm Hg and self-measured BP is recommended to assist in BP control. Recent study and guidance suggest a BP target of <130/80 mm Hg for both primary and recurrent stroke prevention. BP control is reasonable for the prevention of cognitive decline or dementia. CONCLUSIONS: BP targets for the proper management of stroke vary by chronological stage of stroke and by stroke subtype. Furthermore, consideration should be given to control of BP variability, especially in the acute phases of stroke, as it may play a role in conferring longer term outcomes. Elsevier 2019-10-13 /pmc/articles/PMC7803067/ /pubmed/33447751 http://dx.doi.org/10.1016/j.ijchy.2019.100021 Text en © 2019 Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Gorelick, Philip B.
Qureshi, Shakaib
Farooq, Muhammad U.
Management of blood pressure in stroke
title Management of blood pressure in stroke
title_full Management of blood pressure in stroke
title_fullStr Management of blood pressure in stroke
title_full_unstemmed Management of blood pressure in stroke
title_short Management of blood pressure in stroke
title_sort management of blood pressure in stroke
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803067/
https://www.ncbi.nlm.nih.gov/pubmed/33447751
http://dx.doi.org/10.1016/j.ijchy.2019.100021
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