Why would you even expect blood pressure lowering to improve functional outcomes? You are reducing the amount and quantity of oxygen carrying blood to the brain. Does not sound like a good idea.
Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): An international, randomised, open-label, blinded-endpoint, phase 3 trial
The Lancet — Anderson CS, et al. | March 11, 2019
In this trial that included a sample
of nearly 2,200 alteplase-eligible adults with acute ischemic stroke
and systolic blood pressure of ≥ 150 mmHg, researchers assessed
intensive blood pressure lowering vs guideline-recommended blood
pressure lowering in these patients. A total of 1,081 participants were
allocated to the intensive group and 1,115 were allocated to the
guideline group. Among the 2,175 given intravenous alteplase, 1,466
received a standard dose. Intensive blood pressure lowering was
identified as safe, but led to no improved clinical outcome vs guideline
treatment—despite the observed reduction in intracranial hemorrhage.
Results, thus, did not support a major shift towards this treatment for
those receiving alteplase for mild-to-moderate acute ischemic stroke.
Read the full article on The Lancet
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