Blood Pressure Management for Stroke Prevention and in Acute Stroke
Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological...
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| Published in | Journal of stroke Vol. 19; no. 2; pp. 152 - 165 |
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| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Korean Stroke Society
01.05.2017
대한뇌졸중학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2287-6391 1229-4101 2287-6405 |
| DOI | 10.5853/jos.2017.00164 |
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| Abstract | Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering for greater vascular protection, particularly for stroke prevention. For secondary stroke prevention, the evidence of intensive BP lowering benefit is limited since only a single RCT for patients with lacunar infarctions was conducted and most data were driven by exploratory analyses. In acute intracerebral hemorrhage, immediate BP lowering targeting systolic BP<140 mm Hg is recommended by guidelines based on the results from RCTs. In contrast, in acute ischemic stroke, early BP lowering is not usually recommended because of no benefit on functional outcome and future vascular events and potential harm of stroke progression. This review aims to summarize the updated evidence for optimal BP management for primary and secondary stroke prevention and in patients with acute stroke. |
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| AbstractList | Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering for greater vascular protection, particularly for stroke prevention. For secondary stroke prevention, the evidence of intensive BP lowering benefit is limited since only a single RCT for patients with lacunar infarctions was conducted and most data were driven by exploratory analyses. In acute intracerebral hemorrhage, immediate BP lowering targeting systolic BP<140 mm Hg is recommended by guidelines based on the results from RCTs. In contrast, in acute ischemic stroke, early BP lowering is not usually recommended because of no benefit on functional outcome and future vascular events and potential harm of stroke progression. This review aims to summarize the updated evidence for optimal BP management for primary and secondary stroke prevention and in patients with acute stroke. Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering for greater vascular protection, particularly for stroke prevention. For secondary stroke prevention, the evidence of intensive BP lowering benefit is limited since only a single RCT for patients with lacunar infarctions was conducted and most data were driven by exploratory analyses. In acute intracerebral hemorrhage, immediate BP lowering targeting systolic BP<140 mm Hg is recommended by guidelines based on the results from RCTs. In contrast, in acute ischemic stroke, early BP lowering is not usually recommended because of no benefit on functional outcome and future vascular events and potential harm of stroke progression. This review aims to summarize the updated evidence for optimal BP management for primary and secondary stroke prevention and in patients with acute stroke.Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering for greater vascular protection, particularly for stroke prevention. For secondary stroke prevention, the evidence of intensive BP lowering benefit is limited since only a single RCT for patients with lacunar infarctions was conducted and most data were driven by exploratory analyses. In acute intracerebral hemorrhage, immediate BP lowering targeting systolic BP<140 mm Hg is recommended by guidelines based on the results from RCTs. In contrast, in acute ischemic stroke, early BP lowering is not usually recommended because of no benefit on functional outcome and future vascular events and potential harm of stroke progression. This review aims to summarize the updated evidence for optimal BP management for primary and secondary stroke prevention and in patients with acute stroke. Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BPlowering therapy on the stroke risk reduction is well established. The optimal BP target forpreventing stroke and other vascular events have been controversial, but the evidences fromepidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering forgreater vascular protection, particularly for stroke prevention. For secondary stroke prevention, theevidence of intensive BP lowering benefit is limited since only a single RCT for patients withlacunar infarctions was conducted and most data were driven by exploratory analyses. In acuteintracerebral hemorrhage, immediate BP lowering targeting systolic BP<140 mm Hg isrecommended by guidelines based on the results from RCTs. In contrast, in acute ischemic stroke,early BP lowering is not usually recommended because of no benefit on functional outcome andfuture vascular events and potential harm of stroke progression. This review aims to summarizethe updated evidence for optimal BP management for primary and secondary stroke preventionand in patients with acute stroke. KCI Citation Count: 0 |
| Author | Hong, Keun-Sik |
| Author_xml | – sequence: 1 givenname: Keun-Sik surname: Hong fullname: Hong, Keun-Sik |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28592775$$D View this record in MEDLINE/PubMed https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002227914$$DAccess content in National Research Foundation of Korea (NRF) |
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| Copyright | Copyright © 2017 Korean Stroke Society 2017 |
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| Issue | 2 |
| Keywords | Stroke Blood pressure Prevention, Acute ischemic stroke Intracerebral hemorrhage |
| Language | English |
| License | This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 Dr. Keun-Sik Hong has received lecture honoraria from Daiichi-Sankyo Korea, Pfizer Korea, Boehringer Ingelheim Korea, Boryung Pharm, and Hanmi Pharm related to the current topic. |
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| SubjectTerms | blood pressure intracerebral hemorrhage prevention, acute ischemic stroke Review stroke 신경과학 |
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| Title | Blood Pressure Management for Stroke Prevention and in Acute Stroke |
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