Unregistered User If this is not your name, click here.
		Contact Us | Order Now | Journals | Bookstore | Register a colleague
	Select a ChannelAcneAIDS and HIVAllergy OtherAlzheimer'sAnaesthesiology OtherAngina Pectoris/MIAnxietyArthritis OtherAsthmaBack PainBacterial InfectionsBladder CancerBone Marrow TransplantationBreast CancerCardiology OtherCataractCell TransplantationCervical CancerCholesterol/Lipid disordersCirrhosisClinical PharmacologyColorectal CancerCongestive Heart FailureContact DermatitisContraceptionCOPDCystic FibrosisDental and Oral DisordersDepressionDermatology OtherDiabetesDialysisEating DisordersElbowEmergency MedicineEndocrinology OtherEpilepsyErectile DysfunctionFibromyalgiaGastro OtherGeneticsGenitourinary OtherGeriatricsGERD/GastritisGlaucomaH. Pylori/UlcerHaematology OtherHair LossHeadachesHepa/Biliary OtherHepatitisHipHRTHypertensionIBDImmunologyInfectious OtherInfertilityIntensive CareIrritable Bowel SyndromeKneeLeukemiasLiver CancerLung CancerLupusLymphomasMelanomaMenopauseMultiple Sclerosis Nephrology OtherNeurologic OtherNutritional / Metabolic OtherOb/Gyn OtherObesityOncology OtherOphth. OtherOphthalmic SurgeryOrgan TransplantationOrthopaedics OtherOsteoarthritisOsteoporosisOtitisOtorhino. OtherOvarian CancerPaediatricsPainPancreatic CancerParkinson'sPregnancyProstate CancerPsychiatry OtherPulmonary OtherRadiologyRenal CancerRenal FailureRespiratory InfectionsRheumatoid arthritisRheumatology OtherRhinitisSchizophreniaShoulderSleep ApnoeaSleep DisordersSpineStrokeSTDsSurgeryThyroid DisordersTransfusionTransplant Surgery OtherTraumaUrinary IncontinenceUrinary tract infectionsVaccinologyVascular DisordersViral Infections

SEARCH   News Bookstore Medline The Web Meetings & Congresses Complete Doctor's Guide    EXPLORE :    All News   All Webcasts   All Cases   All Meetings & Congresses   All Medical Resources New drugs / indications English Dictionary Medical Dictionary Thesaurus Warning | Privacy | Awards  Favourite Journals  Click here to choose your favourite journals  Favourite Sites  Click here to choose your favourite sites  Languages  Select languageEnglishFrançais

Patients With Elevated Blood Pressure After Stroke May Receive Thrombolytic Therapy CHICAGO -- September 8, 2008 -- Patients who require control of severely elevated blood pressure following a stroke do not appear to be at a higher risk for bleeding or other adverse outcomes after receiving thrombolytic therapy, according to a study in the September issue of Archives of Neurology. "As many as 10% of otherwise eligible patients do not receive tissue plasminogen activator (tPA), the only proved therapy for acute ischemic stroke, because of severely elevated blood pressure," the authors write. "In the past, guidelines recommended against giving tPA to treat acute ischemic stroke when aggressive measures are required to maintain blood pressure lower than 185/110 millimeters of mercury." Sheryl Martin-Schild, MD, then of the University of Texas Health Sciences Center, Houston, Texas, and now of Tulane University Health Sciences Center, New Orleans, Louisiana, and colleagues reviewed the medical records of 178 patients with acute ischaemic stroke who received intravenous tPA within 3 hours. Of these, 50 required treatment for lowering blood pressure before beginning tPA therapy. This included 24 (48%) who received nicardipine, either alone or in combination with labetalol. "We observed several important differences between patients who required blood pressure-lowering treatment and those who did not," the authors write. "They had more severe strokes and their blood glucose concentration was higher, predicting they would have a worse outcome if all other factors were equal. As expected, they more frequently had a history of hypertension." After controlling for these factors, including age, baseline stroke severity, and blood glucose levels, there were no differences in adverse events, poor outcomes, or stroke severity scores at discharge between patients who received antihypertensive treatments and those who did not. "Overall, the results of the present study provide the first experimental support for the revised American Heart Association guidelines allowing tPA therapy in patients requiring aggressive blood pressure management and also provide support for the use of nicardipine in patients with acute ischemic stroke who are eligible for thrombolytic therapy," the authors conclude. "Aggressive control of severely elevated blood pressure is feasible and should not automatically exclude otherwise eligible patients with acute ischemic stroke from receiving thrombolytic therapy." SOURCE: Archives of Neurology E-mail this page to a friend or colleague! To print, use this version