Lowering blood pressure after ischemic stroke does not affect the risk of death

A meta-analysis of 13 randomized controlled trials found lowering blood pressure in patients with early ischemic stroke did not affect the risk of death or dependency. There was also no difference in the risks of recurrent vascular events, recurrent stroke and serious adverse events.

Lead researcher Meng Lee, MD, MPH, of Chang Gung Memorial Hospital in Chiayi, Taiwan, and colleagues published their findings online in Stroke on May 28.

During the acute stage of ischemic stroke, elevated blood pressure occurs in two-thirds to three-quarters of patients, according to Lee et al. To identify the success of blood pressure management, they searched PubMed, EMBASE and Clinicaltrials.gov from 1966 to March 10, 2015 for randomized controlled trials that included patients with ischemic stroke who received a blood pressure lowering intervention.

Their analysis included 12,703 patients, and most of the trials were conducted in Europe. The median time from stroke onset to randomization ranged from 11 to 58 hours.

The researchers said the frequency of a recurrent stroke was low when blood pressure remained untreated during the first two weeks. When patients received treatment within two weeks, there was little risk of infarct extension and neurological deterioration.

Lee et al mentioned that their results only pertained to ischemic stroke and that different types of strokes may have different responses to blood pressure lowering.