Unsolved Issues in the Management of High Blood Pressure in Acute Ischemic Stroke

被引：12

作者：

Hubert, Gordian J. ^{[1
]}

Mueller-Barna, Peter ^{[1
]}

Haberl, Roman L. ^{[1
]}

机构：

[1] Stadtisches Klinikum Munchen GmbH, Klinikum Harlaching, Dept Neurol & Neurol Intens Med, Thalkirchner Str 48, D-80337 Munich, Germany

来源：

INTERNATIONAL JOURNAL OF HYPERTENSION | 2013年 / 2013卷

关键词：

D O I：

10.1155/2013/349782

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

High blood pressure is common in acute stroke patients. Very high as well as very low blood pressure is associated with poor outcome. Spontaneous fall of blood pressure within the first few days after stroke was associated both with neurological improvement and impairment. Several randomized trials investigated the pharmacological reduction of blood pressure versus control. Most trials showed no significant difference in their primary outcome apart from the INWEST trial which found an increase of poor outcome when giving intravenous nimodipine. Nevertheless, useful information can be extracted from the published data to help guide the clinician's decision. Blood pressure should only be lowered when it is clearly elevated, and early after onset, reduction should be moderate but may be achieved rapidly. No clear recommendations can be given on the substances to use; however, care should be taken with intravenous calcium channel blockers and angiotensin receptor antagonists. Two ongoing randomized trials will help to solve the questions on blood pressure management in acute stroke.

引用

页数：5

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