Intensive blood pressure management after stroke reperfusion has negative impact on patient outcomes

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Intensive blood pressure (BP) management during the first 24 hours after successful reperfusion with endovascular thrombectomy (EVT) for acute ischemic stroke may lead to worse clinical outcomes compared to conventional BP management, according to a study.

The study found that patients who received intensive BP management were less likely to achieve functional independence at 3 months after stroke compared to those who received conventional BP management.

The study included 306 EVT-treated patients. They were randomly assigned to receive intensive BP management (target <140 mm Hg) or conventional management (target 140-180 mm Hg) for 24 hours post-enrollment.

The results showed that intensive BP management led to lower functional independence at 3 months (39.4%) compared to conventional management (54.4%). Importantly, rates of hemorrhage and death were similar between the groups.

Nam HS, Kim YD, Heo J, et al; OPTIMAL-BP Trial Investigators. Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke: The OPTIMAL-BP Randomized Clinical Trial. JAMA. 2023;330(9):832-842. doi: 10.1001/jama.2023.14590. PMID: 37668619.