Blood Pressure Management for Stroke Prevention and in Acute Stroke
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초록
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.
Abstract
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.
참고문헌 (83)
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