01350nas a2200145   4500000000100000008004100001100001900042700001400061245006300075250001500138300000800153490000700161520098500168020005101153       2015                            d1 aAnderson Craig1 aCarcel C.00aTiming of blood pressure lowering in acute ischemic stroke  a2015/06/05  a5200 v173 a<p>
Whether there are any benefits without harm from early lowering of blood pressure (BP) in the setting of acute ischemic stroke (AIS) has been a longstanding controversy in medicine. Whilst most studies have consistently shown associations between elevated BP, particularly systolic BP, and poor outcome, some also report that very low BP (systolic &lt;130 mmHg) and large reductions in systolic BP are associated with poor outcomes in AIS. However, despite these associations, the observed U- or J-shaped relationship between BP and outcome in these patients may not be causally related. Patients with more severe strokes may have a more prominent autonomic response and later lower BP as their condition worsens, often pre-terminally. Fortunately, substantial progress has been made in recent years with new evidence arising from well-conducted randomized trials. This review outlines new evidence and recommendations for clinical practice over BP management in AIS.
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