Blood Pressure After Stroke

Wallace, Jan D.

doi:10.1001/jama.1981.03320190035023

Cited by 391 publications

(81 citation statements)

References 13 publications

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“…The general message in guidelines is not to intervene unless for extreme BP values or unusual medical conditions. 1,2 This conservative attitude is based on observations that BP usually settles without intervention during the first week after hospitalization, 3,4 and on our limited understanding of the complex pathophysiology of elevated BP during acute stroke. In hypertensive patients, cerebral autoregulation is potentially shifted to a higher level, 5 whereas in the ischemic penumbra, cerebral autoregulation is disrupted and cerebral perfusion pressure is directly related to systemic BP.…”

mentioning

confidence: 99%

Relationship of Blood Pressure, Antihypertensive Therapy, and Outcome in Ischemic Stroke Treated With Intravenous Thrombolysis

Ahmed

Wahlgren

Brainin

et al. 2009

Stroke

334

136

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mentioning

confidence: 99%

Relationship of Blood Pressure, Antihypertensive Therapy, and Outcome in Ischemic Stroke Treated With Intravenous Thrombolysis

Ahmed

Wahlgren

Brainin

et al. 2009

Stroke

334

136

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“…Além disso, a redução indiscriminada da pressão arterial na fase aguda tem sido relacionada a maior risco de piora do déficit neurológico 4 . No AVE, ocorre redução espontânea dos níveis pressóricos durante os primeiros 10 dias do evento agudo, em média 20 mmHg na pressão arterial sistólica e 10 mmHg na pressão arterial diastólica 9 . Esse fato sugere que, na fase aguda, a pressão arterial se eleva acima dos níveis basais como mecanismo compensatório à isquemia cerebral, o que é potencialmente benéfico nos primeiros dias do evento.…”

Section: Discussionunclassified

Hipertensão induzida farmacologicamente em paciente com isquemia em território vértebro-basilar associada com estenose vertebral bilateral

Oliveira‐Filho¹,

Pedreira²,

Jesus³

et al. 2002

Arq. Neuro-Psiquiatr.

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RESUMO -A hipertensão arterial é um dos principais fatores de risco para acidentes vasculares encefálicos. No entanto, o tratamento agressivo da hipertensão na fase aguda pode estar associada a pior evolução clínica. Apresentamos o caso de uma paciente de 81 anos, admitida após múltiplos infartos encefálicos em circulação posterior. Em vigência de anticoagulação plena, a paciente apresentou deterioração neurológica coincidindo com normalização dos níveis pressóricos. Uma angiorressonância documentou uma estenose vertebral bilateral. Após indução de hipertensão com dopamina, a paciente apresentou rápida melhora dos déficits. Nesse primeiro relato de hipertensão induzida na literatura brasileira, ilustramos o potencial benefício dessa estratégia terapêutica em pacientes com documentado mecanismo hemodinâmico de piora clínica.PALAVRAS-CHAVE: hipertensão arterial sistêmica, infarto cerebral, drogas vasoativas.Pharmacologically-induced hypertension in a patient with vertebro-basilar territory ischemia associated Pharmacologically-induced hypertension in a patient with vertebro-basilar territory ischemia associated Pharmacologically-induced hypertension in a patient with vertebro-basilar territory ischemia associated Pharmacologically-induced hypertension in a patient with vertebro-basilar territory ischemia associated Pharmacologically-induced hypertension in a patient with vertebro-basilar territory ischemia associated with bilateral vertebral stenosis with bilateral vertebral stenosis with bilateral vertebral stenosis with bilateral vertebral stenosis with bilateral vertebral stenosis ABSTRACT -Hypertension is one of the main risk factors for stroke. However, treating hypertension in the acute phase may cause further neurological deterioration. We present a case of an 81-year-old woman, admitted after multiple infarcts in the posterior circulation. While fully anticoagulated, her neurological deficits worsened, coinciding with normalization of her blood pressure levels. Magnetic resonance angiography documented bilateral vertebral artery stenoses. Induced hypertension was followed by rapid clinical improvement. In this first report of induced hypertension in the Brazilian literature, we illustrate the potencial benefit of this therapeutic strategy in patients with documented hemodynamic mechanism of clinical deterioration.KEY WORDS: hypertension, cerebral infarct, vasoactive drugs.A hipertensão arterial sistêmica (HAS) é um dos principais fatores de risco para o desenvolvimento de doenças cerebrovasculares. A relação entre o controle da HAS e redução do risco de acidente vascular encefálico (AVE) é bem estabelecida em estudos epidemiológicos 1 . No entanto, o controle da hipertensão na fase aguda pode ter efeitos deletérios 2-4 . Enquanto em condições normais é possível manter um fluxo sanguíneo cerebral constante independente de grandes variações de pressão arterial, na fase aguda ocorre perda da capacidade de auto-regulação, sendo a perfusão cerebral diretamente dependente dos níveis pressóricos 2 . A relação ben...

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“…This initial BP after haemorrhage is typically higher than after ischaemic stroke. 8,28,29 Frequently, elevated BP levels after stroke decline spontaneously, 28,29 although about one-third of patients remain hypertensive on the 10th day. 29 The BP after a haemorrhagic stroke may remain elevated for a greater duration of time than following ischaemic stroke.…”

Section: Association Of Early Post-stroke Bp Levels With Outcomementioning

confidence: 99%

Blood pressure in acute intracerebral haemorrhage

et al. 2004

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Stroke is one of the leading causes of death worldwide, and spontaneous bleeding into the brain parenchyma, intracerebral haemorrhage (ICH), is a stroke subtype associated with high morbidity and mortality. Overall, it comprises about 15% of all stroke in Caucasians, this figure being much higher in Asians and black people. Blood pressure (BP) appears to play an important role in this disease. We have reviewed available literature on the relationship of BP to the occurrence of primary and secondary ICH, the association of BP levels measured early after stroke with prognosis and complications, and evidence about the effects of early BP lowering treatments on post-stroke outcomes. BP appears to be an important risk factor for primary and secondary ICH. In addition, high BP early after ICH may be detrimental to outcome, possibly contributing to complications such as rebleeding and haematoma enlargement. Few data are available about the effects of early lowering of BP on outcome after ICH with no reliable trial yet conducted. Proper randomised trials are required to establish the effect of early lowering of BP on outcome after ICH.

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Blood Pressure After Stroke

Cited by 391 publications

References 13 publications

Relationship of Blood Pressure, Antihypertensive Therapy, and Outcome in Ischemic Stroke Treated With Intravenous Thrombolysis

Relationship of Blood Pressure, Antihypertensive Therapy, and Outcome in Ischemic Stroke Treated With Intravenous Thrombolysis

Hipertensão induzida farmacologicamente em paciente com isquemia em território vértebro-basilar associada com estenose vertebral bilateral

Blood pressure in acute intracerebral haemorrhage

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