Blood Pressure Reduction in the Acute Phase of an Ischemic Stroke Does Not Improve Short- or Long-Term Dependency or Mortality: A Meta-Analysis of Current Literature

Abstract: The purpose of this study was to perform a meta-analysis of current literature to determine whether lowering blood pressure (BP) during the acute phase of an ischemic stroke improves short- and long-term outcomes. PubMed, Cochrane, and Embase were searched until September 5, 2014 using combinations of the search terms: blood pressure reduction, reduced blood pressure, lowering blood pressure, ischemic stroke, acute stroke, and intra-cerebral hemorrhage. Inclusion criteria were randomized controlled trial and patients with acute stroke (ischemic or hemorrhagic) treated with an antihypertensive agent or placebo. Outcome measures were change in systolic and diastolic BP (SBP, DBP) after treatment, and short- and long-term dependency and mortality rates. A total of 459 studies were identified, and ultimately 22 studies were included in the meta-analysis. The total number of participants in the treatment groups was 5672 (range, 6–2308), and in the control groups was 5416 (range, 6–2033). In most studies, more than 50% of the participants were males and the mean age was more than 60 years. The mean follow-up time ranged from 5 days to 12 months. As expected, treatment groups had a greater decrease in BP than control groups, and this effect was seen with different classes of antihypertensive drugs. Short-term and long-term dependency rates were similar between treatment and control groups (short-term dependency: pooled odds ratio [OR] = 1.041, 95% confidenc...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

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Publication date: Available online 14 February 2019Source: Journal of NeuroradiologyAuthor(s): Fabrizio Sallustio, Caterina Motta, Stefano Merolla, Giacomo Koch, Francesco Mori, Fana Alemseged, Daniele Morosetti, Valerio Ros Da, Roberto Gandini, Marina DiomediABSTRACTBackground and purpose: the effect of intravenous heparin during mechanical thrombectomy for acute ischemic stroke is not clear. We aimed to study efficacy and safety of heparin use during endovascular stroke treatment in a real-world setting.Materials and Methods: patients with anterior circulation stroke were divided, based on the use of intraprocedural hepa...
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
This study aimed to determine the body mass index (BMI) of fatal stroke cases amongst young adults, their clinical characteristics and the association with BMI with risk factors. All cases aged 15-44 years where death was attributed to stroke for whom BMI was available were retrieved from the National Coronial Information System (1/1/2009-31/12/2016). 179 cases were identified: haemorrhagic (165), ischaemic (5), thrombotic (6), mycotic (3), embolic (0). Proportions in each BMI category were: underweight (5.6%), normal weight (37.4%), overweight (27.4%), obese (29.6%). There was a significant linear trend in the proportion ...
Source: Journal of Forensic and Legal Medicine - Category: Forensic Medicine Source Type: research
Conclusions: Patients with RD and acute vertebrobasilar stroke should be thoroughly monitored to prevent ICH after thrombectomy. Our results support performing mechanical thrombectomy in acute stroke patients with large vessel occlusions of the posterior circulation, irrespective of their renal function.Cerebrovasc Dis 2019;47:48 –56
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
ConclusionsTwenty-and-a-half syndrome is reported for the first time. It is due to posterior circulation stroke; in our case, it was due to lacunar infarcts in the pons and medulla, manifesting as one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Conclusion: DACs can safely be used for mechanical thrombectomy of acute M2 occlusions by the ADAPT approach. Their use alone can be a high efficacious treatment of distal intracranial thromboembolic occlusions.
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
ConclusionsReversal of anticoagulation appears safe following LVAD-associated intracranial hemorrhage, though inadequate reversal was common. Resumption of warfarin±antiplatelet was associated with fewer fatal and non-fatal thrombotic events compared to antiplatelets alone, though more non-fatal hemorrhage events occurred.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
AbstractEmpirical evidence on the so-called ‘weekend-effect’ on stroke mortality is mixed with some studies reporting significantly higher mortality for weekend admissions and others finding no difference. The aim of this paper is to enhance the evidence on the weekend-effect on stroke mortality using a rich stroke registry data set from Upper Austria and to discuss underlying reasons for the heterogeneity in results. Using logistic regressions and ordinary least squares regressions with hospital and year-fixed effects, the outcomes of weekend versus weekday admissions are compared for patients admitted to 16 h...
Source: The European Journal of Health Economics - Category: Health Management Source Type: research
Mixed cerebrovascular disease is a diagnostic entity that presents with hemorrhagic and ischemic stroke clinically and/or subclinically. Here, we report a patient with mixed vascular risk factors, who presente...
Source: BMC Neurology - Category: Neurology Authors: Tags: Case report Source Type: research
We read with interest the study by Lehtola et al.1 Anticoagulation (AC) in atrial fibrillation (AF) reduces the risk of ischemic stroke, but at the cost of increasing the risk of hemorrhagic stroke.
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: The Nerve! Readers Speak Source Type: research
Conclusion: The occurrence of visual symptoms was related to some abnormalities in the vector electronystagmography tests, being more frequent in cases of stroke in the vertebrobasilar system, and with oscillopsia and reduced visual acuity as symptoms.RESUMO Altera ções no equilíbrio postural são consequências frequentes no acidente vascular cerebral (AVC). O objetivo deste estudo foi investigar os sintomas e as funções vestibular e oculomotora de sujeitos com tontura após AVC isquêmico e hemorrágico, comparando seus resultados. Métodos: Foram aval ...
Source: Arquivos de Neuro-Psiquiatria - Category: Neurology Source Type: research
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