Evaluation of Hypertension Treatment in Acute Ischemic Stroke

BackgroundTreating hypertension (HTN) in acute ischemic stroke (AIS) is controversial, since both extremely high and low blood pressures (BP) are associated with poor outcomes.ObjectiveThis study was designed to describe and assess the frequency and the factors affecting BP overtreatment in AIS.Methods and materialThis was a retrospective observational study conducted at Lebanese hospitals. BP readings at baseline and after treatment with antihypertensive drugs were recorded. Overtreatment was defined as baseline BP below 220/120 mmHg and an antihypertensive drug was prescribed.ResultsA total of 141 patients were enrolled with a mean age of 76.89 years and 43.3% were males. Overtreatment rate was 62.6%, and was significantly more common in patients with a previous history of HTN and hyperlipidemia. In addition, overtreatment was significantly more common in patients treated with antihypertensive drugs, had high modified Rankin Scale score (>2) at baseline, and had high systolic BP at baseline (p < 0.05). Results of multivariate analysis revealed that the highest risk of overtreatment was significantly shown in patients who had HTN (OR = 4.589, p = 0.017), and who had high systolic BP at baseline (OR = 1.061, p = 0.001).ConclusionBP management in AIS was generally not consistent with the guidelines. This supports the need for further research to investigate the effects of BP overtreatment on patient outcomes.