Navigation Links
Blood Pressure Treatment Can Be Used Against Stroke
Date:9/9/2008

Study finds the therapy can be given in tandem with clot-dissolving drug

TUESDAY, Sept. 9 (HealthDay News) -- It's safe to give the clot-dissolving drug tPA to people with very high blood pressure after they have suffered a stroke, a new study indicates.

The American Heart Association recently updated its stroke treatment guidelines to recommend use of tPA, tissue plasminogen activator, in such cases, "but there was no evidence to support that," said study leader Dr. Sean I. Savitz, co-director of the stroke center at the University of Texas Medical School at Houston. "This is the first evidence," Savitz said.

The study cited a previous report that perhaps 10 percent of people eligible for tPA treatment after a stroke don't get it because of fear that the medication might cause excess bleeding. About 30 percent of people who have strokes have very high blood pressure, defined as 180/110 or higher, Savitz said.

Savitz and his colleagues, including Dr. Sheryl Martin-Schild, now at Tulane University Health Sciences Center, reviewed the medical records of 178 people who had ischemic strokes -- the most common kind, in which a blood clot blocks a brain artery -- and who got intravenous tPA within three hours, the recommended time frame.

Fifty of them had blood pressure high enough to require medication, the researchers said. Their strokes tended to be more severe, and they had higher blood sugar levels, a bad indicator for outcomes. They were given intravenous drugs such as beta blockers and calcium channel blockers to lower blood pressure even as they received the clot-dissolving therapy.

The study was done "to find out the safety of aggressively treating patients with high blood pressure and stroke," Savitz said. "We finally know it's OK, because the bleeding rates were not different, and the outcome rates were not different" in those who did or did not get blood pressure treatment.

The findings were published in the September issue of the journal Archives of Neurology.

Savitz said the study goes part of the way in settling an issue that arose in the 1990s, when tPA was shown to be effective in the first hours after a stroke. But more trials are needed on the treatment of high blood pressure in the hours after a stroke, he said.

"How aggressive should you be in doing it?" he said. "If you lower it too much, you can do damage, because the brain depends on blood pressure to supply it with blood."

Dr. Irene Katzan, a vascular neurologist at the Cleveland Clinic, called the new findings "very intriguing," but she added, "I don't think the data are enough to warrant a change in practice."

At the Cleveland Clinic, the practice is to try to bring down elevated blood pressure, but not usually as aggressively as done in the Texas study, she said.

"The guidelines are straightforward in regard to blood pressure control," Katzan said. "We follow what is recommended for a blood pressure of 185 over 110. Some medication is fine, but aggressive use of blood pressure medication poses something of a contraindication to therapy."

But the Texas report could herald a change in treatment, Katzan said. The Houston group is foremost in stroke treatment and, Katzan added, "I think that other future reports that are similar to this could be used potentially to alter practice," she said.

More information

Learn more about the use of tPA in stroke patients from the American Heart Association.



SOURCES: Sean I. Savitz, M.D., co-director, Stroke Center, University of Texas Medical School at Houston; Irene Katzan, M.D., vascular neurologist, Cleveland Clinic; September 2008, Archives of Neurology


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. UIC leads multi-center study to evaluate blood flow and stroke risk
2. Advanced blood analysis may speed diagnosis of heart attacks
3. New Video from Harvard Medical School: Dos and Don'ts of Checking Blood Pressure at Home, from the Harvard Heart Letter
4. Apples and oranges: Tumor blood vessel cells are remarkably atypical
5. Once-Weekly Diabetes Drug Boosts Blood Sugar Control
6. Pennsylvania Lt. Governor Catherine Baker Knoll Lauds American Red Cross Blood Donor Day
7. Mayor Issues Million Resident Challenge To Educate Central Florida About Blood Pressure
8. Too much calcium in blood may increase risk of fatal prostate cancer
9. Newer Blood Pressure Drug Better for Some Heart Patients, Diabetics
10. Most Patients With Irregular Heartbeat Take Inadequate Blood Thinner Dose
11. Newer Blood Pressure Drug No Better Than Placebo in Preventing Stroke
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... TherapySites, ... today its affiliation with Tennessee Counseling Association. This new relationship allows ... the Tennessee Counseling Association, adding exclusive benefits and promotional offers. , "TCA is ...
(Date:6/27/2016)... NY (PRWEB) , ... June 27, 2016 , ... ... using cutting edge technology to revolutionize the emergency ambulance transport experience for the ... are aware of how Uber has disrupted the taxi industry through the use ...
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in cancer ... they remain in the eye of the beholder, according to experts who offered insights ... American Journal of Managed Care. For the full issue, click here . , ...
(Date:6/26/2016)... Aliso Viejo, California (PRWEB) , ... June 26, 2016 , ... ... for Final Cut Pro X. , "Film editors can give their videos a whole ... artistically," said Christina Austin - CEO of Pixel Film Studios. , ProSlice Levels ...
(Date:6/26/2016)... ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is helping ... fitness app. The fitness app plans to fix the two major problems leading the fitness ... size fits all type program , They don’t eliminate all the reasons people ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Bracket , a leading clinical trial technology and ... platform, Bracket eCOA (SM) 6.0, at the 52 nd ... 2016 in Philadelphia , Pennsylvania.  A demonstration ... of its kind to fully integrate with RTSM, will be ... is a flexible platform for electronic clinical outcomes assessments that ...
(Date:6/23/2016)... and INDIANAPOLIS , June ... receiving a Lilly Diabetes Tomorrow,s Leaders Scholarship is any ... scholarship winners, announced today online at www.diabetesscholars.org ... type 1 diabetes stand in the way of academic ... supported the Foundation,s scholarship program since 2012, and continues ...
(Date:6/23/2016)... LONDON , June 23, 2016 ... environments  Oticon , industry leaders in ... the launch of Oticon Opn ™, the world,s ... world of possibilities for IoT devices.      ... Opn, Oticon introduces a number of ,world firsts,: ...
Breaking Medicine Technology: