Effect of Blood Pressure Lowering in Early Ischemic Stroke. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Lee, Meng; Ovbiagele, Bruce; Hong, Keun-Sik; Wu, Yi-Ling; Lee, Jing-Er; Rao, Neal M.; Feng, Wayne; Saver, Jeffrey L.
• Is Part Of: Stroke. Volume 46:Issue 7(2015)
• Publication Date: 2015-07
• Subjects: Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.115.009552
• Languages: English
• ISSNs: 0039-2499

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background and Purpose—</title> <p>Elevated blood pressure is common in acute stage of ischemic stroke and the strategy to manage this situation is not well established. We therefore conducted a meta-analysis of randomized controlled trials comparing active blood pressure lowering and control groups in early ischemic stroke.</p> </sec> <sec> <title>Methods—</title> <p>Pubmed, EMBASE, and Clinicaltrials.gov from January 1966 to March 2015 were searched to identify relevant studies. We included randomized controlled trials with blood pressure lowering started versus control within 3 days of ischemic stroke onset. The primary outcome was unfavorable outcome at 3 months or at trial end point, defined as dependency or death, and the key secondary outcome was recurrent vascular events. Pooled relative risks and 95% confidence intervals were calculated using random-effects model.</p> </sec> <sec> <title>Results—</title> <p>The systematic search identified 13 randomized controlled trials with 12 703 participants comparing early blood pressure lowering and control. Pooling the results with the random-effects model showed that blood pressure lowering in early ischemic stroke did not affect the risk of death or dependency at 3 months or at trial end point (relative risk, 1.04; 95% confidence interval, 0.96–1.13; <italic>P</italic>=0.35). Also, blood pressure lowering also had neutral effect on recurrent vascular events, as well as on disability or death, all-cause mortality, recurrent stroke, and serious adverse events.</p> </sec> <sec> <title>Conclusions—</title> <p>This meta-analysis suggested blood pressure lowering in early ischemic stroke had a neutral effect on the prevention of death or dependency.</p> </sec> </abstract>