As many as 65 percent of stroke patients are likely to be treated with antihypertensive medications during the first four days of hospitalization, despite current guidelines of the American Stoke Association that recommend against treating all but the most severe cases of hypertension during the first few days following a stroke. A recent retrospective study found that nearly all stroke patients who were being treated for hypertension prior to admission had their medication regimens continued or intensified, and a third who were not taking medications for hypertension had antihypertension treatment initiated during the hospitalization. Study details are published in the July 27 issue of Neurology.
Hypertension (high blood pressure) is common at the time of an ischemic stroke and is believed to be the body’s response that maintains adequate blood flow to the area immediately around the stroke site. Lowering elevated blood pressure through medication, while an appropriate measure in stroke prevention, can result in the extension and worsening of acute stroke symptoms, and has even been shown to result in worse short- and long-term outcomes.
The dangers of antihypertensive therapy in the setting of acute ischemic stroke have been recognized for some time. Despite active efforts to promote clinical guidelines, first established in 1994, little is known about how often, and under what circumstances, antihypertensive agents are used in the treatment of patients with acute ischemic stroke. “We sought to determine whether the use of antihypertensive agents was consistent with guidelines, and if such use placed patients at further risk of negative outcomes,” noted study author Peter Lindenauer, MD, MSc, of Baystate Medical Center and Tufts University School of Medicine, Springfield.
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