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Original Article

The Lancet (10/27/22) DOI: 10.1016/S0140-6736(22)01882-7

Yang, Pengfei; Song, Lili; Zhang, Yongwei; et al.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01882-7/fulltext

Summary

Research out of China investigated whether intensive blood pressure (BP) control is beneficial for patients whose readings are elevated following reperfusion with endovascular treatment. The randomized, multisite study included 816 adult ischemic stroke patients whose systolic numbers remained persistently high after successful thrombectomy. About one-half underwent more intensive treatment, which aimed to bring the number down to 120 mm Hg or lower, while the remainder received less intensive treatment intended to bring BP levels within a desired range of 140–180 mm Hg. The goal was to achieve target BP within 1 hour of intervention and maintain the control for at least 72 hours. The trial ended prematurely due to efficacy and safety concerns. Data showed that patients receiving more intensive therapy were at greater risk for poor functional outcome, based on their modified Rankin scale scores, and for neurological deterioration. Intensive control of systolic BP "should be avoided," the study authors concluded, "to prevent compromising the functional recovery of patients who have received endovascular thrombectomy for acute ischemic stroke due to intracranial large-vessel occlusion."

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