A new study challenges guideline recommendations to rapidly reduce BP in acute ischemic stroke patients to allow for swift thrombolysis.
The observational cluster study showed that patients treated in hospitals that followed the guideline-recommended practice of rapidly reducing BP did no better — and actually showed a trend toward worse outcomes — than those treated in hospitals that did not lower BP, even though this meant fewer patient received thrombolysis.
However, if BP is lowered quickly, there is a greater chance that patients will not be able to receive thrombolysis because the 4.5-hour time limit could be exceeded. But he acknowledged that not rapidly lowering BP will mean fewer patients will be able to receive thrombolysis within the 4.5-hour treatment window.
"The 185/110 mmHg blood pressure level is an arbitrary threshold that was chosen for the original thrombolysis stroke trials," he said."I believe we need trials to investigate whether we can give thrombolysis safely to patients with higher blood pressure levels than this, without needing to rapidly reduce the pressure.
Cerebrovascular Accident CVA - Cerebrovascular Accident Thromboembolism Hypertension Blood Ischemic Stroke Ischaemic Stroke Clinical Guidelines Guidelines Hospitals Cerebral Hemorrhage Cerebral Bleeding Intracerebral Hemorrhage Intracerebral Bleeding Cerebral Haemorrhage Intracerebral Haemorrhage Intracranial Hemorrhage Intracranial Bleeding Intracranial Haemorrhage
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