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Antihypertensive Drugs Immediately After Stroke Admission Don't Improve Short-Term Survival — Physician’s First Watch

Medical News |
November 18, 2013

Antihypertensive Drugs Immediately After Stroke Admission Don't Improve Short-Term Survival

By Kelly Young

Reducing blood pressure during hospital stay of patients admitted for ischemic stroke fails to improve clinical outcomes, according to a study published in JAMA and presented at the American Heart Association's annual meeting in Dallas.

Roughly 4000 patients in China who were admitted for acute ischemic stroke with a systolic BP of 140-220 mm Hg (and diastolic below 120 mm Hg) were randomized to receive or not receive antihypertensive therapy immediately after hospitalization. All patients discontinued their home BP medications during their hospital stays.

By day 14, mean systolic BP was lower in the antihypertensive group than the control group (135.2 vs. 143.7 mm Hg). However, the primary outcome, a composite of death and major disability, did not differ between the two groups at day 14.

The authors conclude: "These findings suggest that unless a patient's systolic blood pressure is 220 mm Hg or more or diastolic pressure is 120 mm Hg or more, the decision to lower blood pressure with antihypertensive treatment in patients with acute ischemic stroke does not improve or worsen outcome and therefore should be based on individual clinical judgment."

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