Open AccessReview of major trials of acute blood pressure management in stroke
Author(s) -
Thompson G. Robinson,
Jatinder S. Minhas,
Joseph Miller
Publication year - 2021
Publication title -
journal of cerebral blood flow and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.167
H-Index - 193
eISSN - 1559-7016
pISSN - 0271-678X
DOI - 10.1177/0271678x211004310
Subject(s) - medicine , acute stroke , clinical trial , stroke (engine) , intensive care medicine , psychological intervention , blood pressure , clinical practice , ischaemic stroke , emergency medicine , physical therapy , ischemia , tissue plasminogen activator , psychiatry , mechanical engineering , engineering
Over the last two decades, there have been a number of major landmark clinical trials, classified as “major” as they sought to address clear clinical practice driven questions, in a pragmatic yet robust trial design, using a large powered sample size (n > 1000), in order to help improve patient outcome through informing guidelines. A commonality across all stroke sub-types included in these trials is the tendency to acute hypertensive crises within the acute stroke period. This phenomenon is associated with greater stroke complications and worsened overall prognosis. Multiple trials have attempted to address the issue of acute blood pressure management during the acute stroke period, with consideration for timing, magnitude of lowering, agent and relationship to other interventions. This review will consider the major clinical trials performed in ischaemic and haemorrhagic stroke that test the hypothesis that acute BP reduction improves clinical outcomes.