Stroke Recovery

Ivanhoe Newswire
Tuesday, October 28, 2003; 12:00 AM

(Ivanhoe Newswire) - When a patient has a stroke, their blood pressure is generally high. Now a new study further fuels the controversy as to what blood pressure should be in the first 24 hours after a stroke. This new study, conducted by doctors in Brazil, finds it is dangerous to lower blood pressure in the first 24 hours.

Doctors say high blood pressure is the main risk factor for stroke. But what is not understood as clearly is the role of blood pressure immediately following stroke. One theory is that by lowering blood pressure after a stroke, the amount of blood to damaged tissue is lessened. As a result, less function can be retained.

The Brazilian physicians studied 115 patients who were admitted to the hospital for stroke. All patients had their blood pressure lowered, either spontaneously or with medication, within 24 hours of the event. After three months, 44 patients had a poor outcome. These patients needed help with walking, eating, and taking care of themselves. The researchers report the risk of poor outcome almost doubled with every 10 percent decrease in systolic blood pressure during the first 24 hours.

In an accompanying editorial, neurologists from the University of Virginia write, "The urgency of determining the optimal management of BP in patients with acute stroke has increased as data have suggested that acute hypertension is common and harmful effects may result from aggressive BP reduction." They say if blood pressure is lowered in the first 24 hours it should be done carefully and monitored continuously.

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SOURCE: Neurology, 2003;61:1047-1051