Strict control of blood pressure could help make stroke care safer

THURSDAY, Feb. 7, 2019 (HealthDay News) – A new study reveals that intensive lowering of blood pressure is safe for patients treated with clot medications after a stroke.

Bleeding is a major potential side effect of anticoagulant medications. However, the use of extreme hypotension to reduce this risk in patients taking these drugs after ischemic stroke is controversial. (The ischemic stroke is the result of a blockage of blood flow to the brain.)

To evaluate the safety and effectiveness of the intensive lowering of blood pressure, researchers examined more than 2,000 stroke patients treated in 110 hospitals in 15 countries between 2013 and 2018.

The investigators specifically looked at systolic blood pressure – this is the highest figure in the blood pressure reading. The researchers evaluated whether a reduction to less than 140 mm Hg could safely reduce the risk of brain bleeding and post-stroke disability better than the usual goal of less than 180 mm Hg over three days.

After the intensive diet, far fewer patients had bleeding to the brain and severe bleeding was also less likely. But both groups had similar disability levels after 90 days.

In addition, researchers have identified no harm badociated with an intensive lowering of blood pressure.

Further research is needed to understand why reducing the risk of bleeding in the brain has not improved outcomes in patients, the study authors said.

The results were presented at a meeting of the American Stroke Association in Honolulu and published at The lancet February 7th.

"This study now clearly shows more intensive control of blood pressure than is currently recommended [clot-busting] safer treatment, reducing the risk of serious cerebral hemorrhage, "said chief investigator Craig Anderson, executive director of the George Institute for Global Health, China.

The co-principal investigator, Tom Robinson, said in an institute press release that the findings underscore the need for further research to better understand the underlying mechanisms of early intensive lowering of the disease. blood pressure, "since the reduction in the number of cerebral hemorrhages did not result in improved recovery for patients."

Robinson runs the Cardiovascular Research Center at the University of Leicester, England.

Worldwide, stroke accounts for nearly 5% of lives lost due to premature death or disability, and 10% of all deaths.

More information

The National Stroke Association has more about ischemic strokes.