| News - Hypertension Week of October 26, 2003/ Vol. 2 No. 43 |
| Lowering Blood Pressure Soon After Stroke Can Hurt Recovery |
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Lowering the blood pressure of a person soon after they are stricken by a stroke can hurt their chances of recovery, according to a study published in the October 28 issue of Neurology. Researchers studied the blood pressure of 115 stroke patients whose blood pressure dropped either spontaneously or with medication during the first 24 hours after stroke. Three months later, 44 of the patients suffered at least moderate disability. The risk of a poor outcome almost doubled with every 10 percent decrease in systolic blood pressure during the first 24 hours after a stroke. "The amount of blood pressure variation made the difference between a poor outcome and a good one," said study author Dr. Jamary Oliveira-Filho, of Federal University of Bahia in Salvador, Brazil. "Blood pressure is only one variable in the outcome, but even small changes can make a difference in the big picture." According
to the researchers, a significant drop in blood pressure in the hours after a
stroke reduces blood flow to brain tissue, which can cause more damage. "While
lower is better for preventing first and subsequent strokes, there is a growing
sentiment that high is good in the acute phase," said Dr. Karen C. Johnston,
of the University of Virginia Health System, in an accompanying editorial. "Blood
pressure reduction in the acute phase should be avoided if at all possible." Oliveira-Filho and Johnston both noted the need for a randomized trial to study whether it is appropriate to treat blood pressure in the first 24 hours. "The question of what is the ideal blood pressure in the acute phase remains a controversy," said Oliveira-Filho.
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