Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/1822/57850 |
Resumo: | Altered blood pressure (BP) is a common phenomenon in acute ischemic stroke (AIS), with high BP being the most frequent scenario. The pathophysiology of BP changes in AIS is complex and only partially understood. The available evidence indicates that extremely high BP during AIS is associated with a poor outcome. Importantly, the observed relationship between BP and stroke outcome may or may not be causally related. Higher baseline BPs in focal cerebral ischemia may indicate preexisting hypertension, but may also be an effect of both nonspecific and stroke-related factors. Although antihypertensive therapy effectively reduces BP in AIS, studies on early BP lowering in AIS produce conflicting results in terms of functional outcome and mortality. Systematic reviews on BP management in AIS did not result in clinically applicable conclusions in general. However, the investigation on the effect of BP and its alterations in AIS are hampered by various important methodological issues. This position statement was prepared by a group of experts from the European Society of Hypertension and invited neurologists to discuss the main reasons for the discrepancies in the current evidence on the prognosis and treatment of altered BP in AIS which should be taken into account in future studies. |
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Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the BrainAcute ischemic strokeArterial hypertensionBlood pressureCiências Médicas::Medicina BásicaScience & TechnologyAltered blood pressure (BP) is a common phenomenon in acute ischemic stroke (AIS), with high BP being the most frequent scenario. The pathophysiology of BP changes in AIS is complex and only partially understood. The available evidence indicates that extremely high BP during AIS is associated with a poor outcome. Importantly, the observed relationship between BP and stroke outcome may or may not be causally related. Higher baseline BPs in focal cerebral ischemia may indicate preexisting hypertension, but may also be an effect of both nonspecific and stroke-related factors. Although antihypertensive therapy effectively reduces BP in AIS, studies on early BP lowering in AIS produce conflicting results in terms of functional outcome and mortality. Systematic reviews on BP management in AIS did not result in clinically applicable conclusions in general. However, the investigation on the effect of BP and its alterations in AIS are hampered by various important methodological issues. This position statement was prepared by a group of experts from the European Society of Hypertension and invited neurologists to discuss the main reasons for the discrepancies in the current evidence on the prognosis and treatment of altered BP in AIS which should be taken into account in future studies.info:eu-repo/semantics/publishedVersionLippincott, Williams & WilkinsUniversidade do MinhoGąsecki, DariuszCoca, AntonioCunha, Pedro Miguel Guimarães MarquesHering, DagmaraManios, EfstathiosLovic, DraganZaninelli, AugustoSierra, CristinaKwarciany, MariuszNarkiewicz, KrzysztofKaraszewski, Bartosz2018-062018-06-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/57850engGasecki, D., Coca, A., Cunha, P., Hering, et. al. (2018). Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management position of the ESH Working Group on Hypertension and the Brain. Journal of Hypertension, 36(6), 1212-12210263-63521473-559810.1097/HJH.000000000000170429621070https://journals.lww.com/jhypertension/Abstract/2018/06000/Blood_pressure_in_acute_ischemic_stroke__.2.aspxinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T11:58:42Zoai:repositorium.sdum.uminho.pt:1822/57850Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:48:28.146059Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain |
title |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain |
spellingShingle |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain Gąsecki, Dariusz Acute ischemic stroke Arterial hypertension Blood pressure Ciências Médicas::Medicina Básica Science & Technology |
title_short |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain |
title_full |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain |
title_fullStr |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain |
title_full_unstemmed |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain |
title_sort |
Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain |
author |
Gąsecki, Dariusz |
author_facet |
Gąsecki, Dariusz Coca, Antonio Cunha, Pedro Miguel Guimarães Marques Hering, Dagmara Manios, Efstathios Lovic, Dragan Zaninelli, Augusto Sierra, Cristina Kwarciany, Mariusz Narkiewicz, Krzysztof Karaszewski, Bartosz |
author_role |
author |
author2 |
Coca, Antonio Cunha, Pedro Miguel Guimarães Marques Hering, Dagmara Manios, Efstathios Lovic, Dragan Zaninelli, Augusto Sierra, Cristina Kwarciany, Mariusz Narkiewicz, Krzysztof Karaszewski, Bartosz |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade do Minho |
dc.contributor.author.fl_str_mv |
Gąsecki, Dariusz Coca, Antonio Cunha, Pedro Miguel Guimarães Marques Hering, Dagmara Manios, Efstathios Lovic, Dragan Zaninelli, Augusto Sierra, Cristina Kwarciany, Mariusz Narkiewicz, Krzysztof Karaszewski, Bartosz |
dc.subject.por.fl_str_mv |
Acute ischemic stroke Arterial hypertension Blood pressure Ciências Médicas::Medicina Básica Science & Technology |
topic |
Acute ischemic stroke Arterial hypertension Blood pressure Ciências Médicas::Medicina Básica Science & Technology |
description |
Altered blood pressure (BP) is a common phenomenon in acute ischemic stroke (AIS), with high BP being the most frequent scenario. The pathophysiology of BP changes in AIS is complex and only partially understood. The available evidence indicates that extremely high BP during AIS is associated with a poor outcome. Importantly, the observed relationship between BP and stroke outcome may or may not be causally related. Higher baseline BPs in focal cerebral ischemia may indicate preexisting hypertension, but may also be an effect of both nonspecific and stroke-related factors. Although antihypertensive therapy effectively reduces BP in AIS, studies on early BP lowering in AIS produce conflicting results in terms of functional outcome and mortality. Systematic reviews on BP management in AIS did not result in clinically applicable conclusions in general. However, the investigation on the effect of BP and its alterations in AIS are hampered by various important methodological issues. This position statement was prepared by a group of experts from the European Society of Hypertension and invited neurologists to discuss the main reasons for the discrepancies in the current evidence on the prognosis and treatment of altered BP in AIS which should be taken into account in future studies. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-06 2018-06-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1822/57850 |
url |
http://hdl.handle.net/1822/57850 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Gasecki, D., Coca, A., Cunha, P., Hering, et. al. (2018). Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management position of the ESH Working Group on Hypertension and the Brain. Journal of Hypertension, 36(6), 1212-1221 0263-6352 1473-5598 10.1097/HJH.0000000000001704 29621070 https://journals.lww.com/jhypertension/Abstract/2018/06000/Blood_pressure_in_acute_ischemic_stroke__.2.aspx |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Lippincott, Williams & Wilkins |
publisher.none.fl_str_mv |
Lippincott, Williams & Wilkins |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799132246478684160 |