New treatment options for hypertension during acute ischemic or hemorrhagic stroke

Spence, J. David

doi:10.1007/s11936-007-0019-0

Cited by 6 publications

(4 citation statements)

References 34 publications

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“…Ischemic stroke and intracerebral hemorrhage may be associated with a worse outcome when there is extremely high blood pressure at onset [24]. Our ICH patients that arrived ≤3 h usually presented with higher SBP.…”

Section: Discussionmentioning

confidence: 93%

Clinical Features Associated with Early Hospital Arrival after Acute Intracerebral Hemorrhage: Challenges for New Trials

Valiente

Alves²,

Silva³

et al. 2008

Cerebrovasc Dis

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Background: Early hospital admission followed by correct diagnosis with minimum delay is a prerequisite for successful new interventions in acute intracerebral hemorrhage (ICH). The aim of this study was to evaluate clinical features associated with early hospital arrival in ICH patients and their influence on the outcome. Methods: Data from all patients arriving within 24 h of the ICH onset were prospectively collected at 2 stroke centers in São Paulo, Brazil. The cutoff of 3 h was chosen to select 2 groups: 0–3 h (early) and >3–24 h (late). Results: We identified 91 ICH patients (mean age 57.9 years, 62% men, 63% white) admitted within the first 24 h of symptom onset between March 2004 and April 2005. Systolic blood pressure, mean arterial pressure and pulse pressure were significantly higher in patients arriving within 3 h. Patients that arrived early also had a higher NIHSS score (p = 0.003), a lower Glasgow Coma Score (p = 0.001) and presence of intraventricular hemorrhage (p = 0.02). Lower ICH scores were more frequent in those that arrived late. Fourteen patients showed hematoma enlargement and the majority of them (n = 13) were admitted within the first 3 h from symptom onset (p = 0.01). Patients who arrived within the 3-hour window had a higher 30-day mortality (p = 0.0008) and a worse Rankin score after 6 months (p = 0.001). Conclusions: Treatment decisions in acute ICH may need to establish new combined approaches to maximize the number of eligible patients for early therapy considering the interactions between independent outcome predictors presented at early onset.

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Section: Discussionmentioning

confidence: 93%

Clinical Features Associated with Early Hospital Arrival after Acute Intracerebral Hemorrhage: Challenges for New Trials

Valiente

Alves²,

Silva³

et al. 2008

Cerebrovasc Dis

View full text Add to dashboard Cite

show abstract

“…Previous research has suggested this association may be due an increased likelihood of a fatal cerebral edema in high SBP patients. 24,25 The association between low SBP (first quintile) and mortality may be due to inadequacy of cerebral perfusion due to low mean arterial pressure and subsequent reduce cerebral blood flow. …”

Section: Context Of Findingsmentioning

confidence: 99%

The shock index predicts acute mortality outcomes in stroke

McCall¹,

Musgrave²,

Potter³

et al. 2015

International Journal of Cardiology

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“…5 Guidelines suggest various approaches for the lowering of blood pressure, including intravenous labetalol, nitroglycerine paste, intravenous nicardipine, and, in extreme cases, intravenous nitroprusside. 5,6 Two articles in this issue of Hypertension shed some light on this problem. Geeganage and Bath 7 performed a metaregression analysis of 37 acute ischemic stroke trials involving blood pressure reduction in 9008 patients.…”

mentioning

confidence: 99%