We need a protocol on blood pressure management post stroke. Too high, not good, too low, not good. Otherwise with no protocol your doctor is just guessing, you better hope they guess correctly.
High Systolic BP After EVT for Stroke Tied to Poor Outcomes December 2020
The latest here:
Low Blood Pressure Associated With Increased Risk of Death Following a Stroke
While hypertension has been a well-established risk factor for stroke and for deaths, it turns out that having low blood pressure is just as great a risk factor for death after stroke, according to a study published in Stroke.
“Lower average blood pressure, measured in the outpatient setting, was associated with increased risk of death after a stroke event,” said Hugo J. Aparicio, MD, Boston University School of Medicine, Boston, Massachusetts. “In addition, this higher risk of death appeared to happen particularly in patients who were smokers, or had a diagnosis of cardiac disease, cancer or dementia.”
Current national guidelines recommend treating high blood pressure after stroke, but the timing of this treatment and whether to treat patients in a normal, low or mildly elevated range of blood pressures has been debated.
The researchers identified nearly 30,000 Veteran patients with a first ischaemic stroke who had outpatient blood pressure measurements within the previous 18 months prior to stroke. They divided this group by blood pressure categories and followed them over time all-cause and cardiovascular mortality, with the hypothesis that both very high and very low blood pressure values contribute to higher mortality risk.
Results showed that people with lower blood pressure had the highest mortality, especially when they looked at a subgroup of patients with at least 1 comorbidity of smoking, cardiovascular disease, cancer or dementia.
“Our study suggests that patients who have had a stroke and who have a history of low to low-normal blood pressures -- some 10% of patients -- are at high risk of mortality,” said Dr. Aparicio.
The researchers hope that by investigating the factors that contribute to death after stroke, patients, families and practitioners can better understand and recognise conditions, like low blood pressure, that may predict their health outcomes.
“Ideally, this information can encourage better prevention, diagnosis, and treatment of risk factors such as smoking, heart disease, and cancer, so that if a stroke does occur patients have a better chance at recovery and survival,” said Dr. Aparicio.
Reference: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033195
SOURCE: Boston University School of Medicine
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