Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain.

Abstract:

:: Altered blood pressure (BP) is a common phenomenon in acute ischemic stroke (AIS), with high BP being the most frequent scenario. The pathophysiology of BP changes in AIS is complex and only partially understood. The available evidence indicates that extremely high BP during AIS is associated with a poor outcome. Importantly, the observed relationship between BP and stroke outcome may or may not be causally related. Higher baseline BPs in focal cerebral ischemia may indicate preexisting hypertension, but may also be an effect of both nonspecific and stroke-related factors. Although antihypertensive therapy effectively reduces BP in AIS, studies on early BP lowering in AIS produce conflicting results in terms of functional outcome and mortality. Systematic reviews on BP management in AIS did not result in clinically applicable conclusions in general. However, the investigation on the effect of BP and its alterations in AIS are hampered by various important methodological issues. This position statement was prepared by a group of experts from the European Society of Hypertension and invited neurologists to discuss the main reasons for the discrepancies in the current evidence on the prognosis and treatment of altered BP in AIS which should be taken into account in future studies.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Gąsecki D,Coca A,Cunha P,Hering D,Manios E,Lovic D,Zaninelli A,Sierra C,Kwarciany M,Narkiewicz K,Karaszewski B

doi

10.1097/HJH.0000000000001704

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

1212-1221

issue

6

eissn

0263-6352

issn

1473-5598

journal_volume

36

pub_type

杂志文章
  • Spironolactone improves endothelial and cardiac autonomic function in non heart failure hemodialysis patients.

    abstract:OBJECTIVES:Hemodialysis patients have a cardiovascular mortality rate of 20-40 times that of the general population. Aldosterone inhibition by spironolactone has exerted beneficial, prognostically significant cardiovascular effects in patients with heart failure maintained on hemodialysis or peritoneal dialysis. Our ai...

    journal_title:Journal of hypertension

    pub_type: 临床试验,杂志文章

    doi:10.1097/HJH.0b013e32835f955c

    authors: Flevari P,Kalogeropoulou S,Drakou A,Leftheriotis D,Panou F,Lekakis J,Kremastinos D,Vlahakos DV

    更新日期:2013-06-01 00:00:00

  • Loss of maximum attenuation and receptor reserve for isoprenaline at the beta 2-adrenoceptors of the portal veins of hypertensive rats.

    abstract:OBJECTIVE:To test the hypothesis that vascular beta 2-adrenoceptor hyporesponsiveness in spontaneously hypertensive rats (SHR) is not induced by increased blood pressure or venous hypertrophy. DESIGN:We compared the attenuating effects or isoprenaline, sodium nitroprusside and verapamilon the portal veins from Wistar-...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-199509000-00013

    authors: Doggrell SA,Surman AJ

    更新日期:1995-09-01 00:00:00

  • Orlistat in hypertensive overweight/obese patients: results of a randomized clinical trial.

    abstract:OBJECTIVE:To assess the effect of orlistat plus diet compared with diet alone in promoting weight loss and blood pressure reduction in hypertensive, overweight/obese patients. DESIGN:A pragmatic randomized, controlled trial. SETTING:Hypertension clinic of a university hospital. PATIENTS:Hypertensive patients aged 18...

    journal_title:Journal of hypertension

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00004872-200311000-00026

    authors: Bloch KV,Salles GF,Muxfeldt ES,Da Rocha Nogueira A

    更新日期:2003-11-01 00:00:00

  • Angiotensin II accelerates endothelial progenitor cell senescence through induction of oxidative stress.

    abstract:OBJECTIVES:Recent studies have revealed an association between coronary risk factors and both the number and function of bone marrow-derived endothelial progenitor cell (EPC). We investigated the effect of angiotensin II (Ang II) on EPC senescence, leading to the impairment of proliferative activity. METHODS AND RESUL...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-200501000-00018

    authors: Imanishi T,Hano T,Nishio I

    更新日期:2005-01-01 00:00:00

  • Persistent effect of early, brief angiotensin-converting enzyme inhibition on segmental pressure dependency of aortic stiffness in spontaneously hypertensive rats.

    abstract:OBJECTIVE:The effect of brief, prehypertensive therapy by angiotensin-converting enzyme inhibition (ACEi) with perindopril on the structure and function of large arteries was studied in rats. METHODS:Spontaneously hypertensive rats (SHR) received perindopril (3 mg/kg per day) between the ages of either 6 and 10 weeks ...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0b013e3283562e35

    authors: Ng K,Butlin M,Avolio AP

    更新日期:2012-09-01 00:00:00

  • Renal protective effects of N-acetyl-Ser-Asp-Lys-Pro in deoxycorticosterone acetate-salt hypertensive mice.

    abstract:BACKGROUND:Hypertension-induced renal injury is characterized by inflammation, fibrosis and proteinuria. Previous studies have demonstrated that N-acetyl-Ser-Asp-Lys-Pro (Ac-SDKP) inhibits renal damage following diabetes mellitus and antiglomerular basement membrane nephritis. However, its effects on low-renin hyperten...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0b013e32834103ee

    authors: Rhaleb NE,Pokharel S,Sharma U,Carretero OA

    更新日期:2011-02-01 00:00:00

  • Effect of exposure to PM2.5 on blood pressure: a systematic review and meta-analysis.

    abstract:BACKGROUND:Comprehensive studies have confirmed that particulate matter air pollution could trigger myocardial infarction, heart failure and reduce heart rate variability; however, its effect on blood pressure (BP) remains controversial. Therefore, we did a systematic review and meta-analysis to investigate the associa...

    journal_title:Journal of hypertension

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/HJH.0000000000000342

    authors: Liang R,Zhang B,Zhao X,Ruan Y,Lian H,Fan Z

    更新日期:2014-11-01 00:00:00

  • Effect of neonatal sympathectomy on the development of structural vascular changes in angiotensin II-treated rats.

    abstract:BACKGROUND:In a previous study, we found that neonatal sympathectomy prevented the development of angiotensin II (ANG II)-induced hypertension but not the development of structural changes in small mesenteric arteries. OBJECTIVES:To investigate further the dissociation between hypertension and structural vascular chan...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-199816010-00012

    authors: Simon G,Csiky B

    更新日期:1998-01-01 00:00:00

  • An index of peripheral vascular resistance.

    abstract::An index of peripheral vascular resistance, derived from directly measured arterial pressure, has been developed and tested in an animal model. Assuming a mono-exponential character for diastole, the time constant for direct arterial pressure decay in the central aorta was obtained with high-fidelity recording techniq...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-198512000-00009

    authors: Walsh JT,Mehta SK,Topham WS,Goldberg AD

    更新日期:1985-12-01 00:00:00

  • Effect of antihypertensive therapy on development of incident conduction system disease in hypertensive patients.

    abstract:BACKGROUND:Previous work has demonstrated that treatment of hypertensive patients with the angiotensin-converting enzyme inhibitor lisinopril was associated with a reduced incidence of a composite conduction system disease endpoint and also left bundle branch block (LBBB) compared with chlorthalidone therapy. The relat...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0000000000001915

    authors: Okin PM,Kjeldsen SE,Devereux RB

    更新日期:2019-03-01 00:00:00

  • Frailty and the relationship between blood pressure and mortality in elderly patients with type 2 diabetes (Zwolle Outpatient Diabetes project Integrating Available Care-34).

    abstract:OBJECTIVE:We aimed to investigate whether adjustment for frailty influences the relationship of blood pressure with mortality in elderly patients with type 2 diabetes mellitus (T2DM). METHODS:Patients aged 60 years and older (n = 858) were selected from a prospective observational cohort study of primary care patients...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0000000000000555

    authors: van Hateren KJ,Hendriks SH,Groenier KH,Bakker SJ,Bilo HJ,Kleefstra N,Landman GW

    更新日期:2015-06-01 00:00:00

  • Crucial importance of using a sliding calliper to measure distance for carotid-femoral pulse wave velocity assessment.

    abstract:BACKGROUND AND OBJECTIVES:In the past, different methods have been used to measure the carotid-femoral distance for the assessment of pulse wave velocity (PWV). However, the latest consensus published advises to use 80% of the direct straight carotid-femoral distance (D(0.8)) using either a flexible tape or a sliding c...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0b013e32835e2a2f

    authors: Levi-Marpillat N,Desamericq G,Akakpo S,Affes-Ayadi H,Tropeano AI,Millasseau S,Macquin-Mavier I

    更新日期:2013-05-01 00:00:00

  • Hypertension and childhood migration: a nationwide study of 2.7 million adolescents.

    abstract:OBJECTIVES:Immigration studies can shed light on hypertension development and reveal high-risk populations. To this end, we investigated the association between age at immigration and hypertension occurrence at adolescence among immigrants to Israel. METHODS:We analyzed cross-sectional data on 2 681 294 adolescents as...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0000000000001957

    authors: Peled A,Gordon B,Twig G,Grossman E,Matani D,Derazne E,Afek A

    更新日期:2019-04-01 00:00:00

  • Angiotensin converting enzyme inhibition reduces the expression of transforming growth factor-beta1 and type IV collagen in diabetic vasculopathy.

    abstract:OBJECTIVE:The purpose of this study was to assess the role of transforming growth factor (TGF)-beta1 in the development of diabetes-associated mesenteric vascular hypertrophy and in the antitrophic effect of angiotensin converting enzyme inhibitors. DESIGN AND METHODS:Streptozotocin-induced diabetic and control Spragu...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-199816110-00006

    authors: Rumble JR,Gilbert RE,Cox A,Wu L,Cooper ME

    更新日期:1998-11-01 00:00:00

  • Effects of chronic treatment with losartan on blood pressure, endothelin-like immunoreactivity and nitric oxide in normotensive rats.

    abstract:BACKGROUND:Losartan is a new angiotensin II type 1 (AT1) receptor antagonist and an antihypertensive drug. Nitric oxide is a vasodilating agent and endothelins are powerful vasoconstrictors, both synthesized by and released from endothelial cells. Angiotensin II promotes the release of endothelins in cultured cells and...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:

    authors: Sacerdote A,Cosenzi A,Bocin E,Molino R,Seculin P,Plazzotta N,Luxich E,Bellini G

    更新日期:1995-12-01 00:00:00

  • Alcohol intake and cardiovascular mortality in hypertensive patients: report from the Department of Health Hypertension Care Computing Project.

    abstract:OBJECTIVE:To determine the benefits and risks of drinking alcohol in treated hypertensives. DESIGN:A prospective study of 6,369 hypertensives (3,161 men) attending primarily hospital clinics in the UK. METHODS:Relative risks both for drinkers compared with non-drinkers and for level of alcohol consumption were calcul...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-199509000-00004

    authors: Palmer AJ,Fletcher AE,Bulpitt CJ,Beevers DG,Coles EC,Ledingham JG,Petrie JC,Webster J,Dollery CT

    更新日期:1995-09-01 00:00:00

  • Thiazide diuretics, endothelial function, and vascular oxidative stress.

    abstract:OBJECTIVES:Increased endothelial production of reactive oxygen species and decreased nitric oxide bioactivity, associated with the upregulation of monocyte chemoattractant protein (MCP)-1 and lectin-like oxidized low-density lipoprotein receptor (LOX)-1, link hypertension with atherogenesis. We investigated whether the...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0b013e3282f3e39d

    authors: Zhou MS,Schulman IH,Jaimes EA,Raij L

    更新日期:2008-03-01 00:00:00

  • Female sexual dysfunction in essential hypertension: a common problem being uncovered.

    abstract:OBJECTIVES:Female sexual dysfunction (FSD) is increasingly attracting more scientific and public interest, and represents a poorly investigated issue in patients with essential hypertension. We evaluated the prevalence of sexual dysfunction in hypertensive women compared with normotensive women according to age, hypert...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/01.hjh.0000251898.40002.5b

    authors: Doumas M,Tsiodras S,Tsakiris A,Douma S,Chounta A,Papadopoulos A,Kanellakopoulou K,Giamarellou H

    更新日期:2006-12-01 00:00:00

  • Relationship between exercise systolic blood pressure and left ventricular geometry in overweight, mildly hypertensive patients.

    abstract:OBJECTIVE:To examine the association between the graded exercise systolic blood pressure (SBP) response and left ventricular (LV) geometric structure in patients with untreated mild hypertension. PARTICIPANTS:The study included 80 sedentary, overweight patients (43 female and 37 male) with unmedicated high normal bloo...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-200402000-00026

    authors: Pierson LM,Bacon SL,Sherwood A,Hinderliter AL,Babyak M,Gullette EC,Waugh R,Blumenthal JA

    更新日期:2004-02-01 00:00:00

  • Influence of converting enzyme inhibition on the hormonal and renal adaptation to hyper- and hyponatraemic dehydration.

    abstract::The present study was designed to investigate in rats the influence of converting enzyme inhibition with captopril on blood pressure, plasma urea, plasma renin concentration (PRC), plasma aldosterone and plasma vasopressin, and to define the interrelationships between PRC and these variables during equal degrees of ei...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-198604000-00008

    authors: Gardes J,Gonzalez MF,Corvol P,Ménard J

    更新日期:1986-04-01 00:00:00

  • Hypertension in blacks: insights from Africa.

    abstract::Although the consequences of hypertension are universal, blacks (African-Americans or indigenous Africans) have been the subject of a differential approach to causation, outcome, and treatment. Blacks have a greater propensity to salt sensitivity and suppressed plasma renin suggesting a predisposition to sodium retent...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0000000000001171

    authors: Rayner BL,Spence JD

    更新日期:2017-02-01 00:00:00

  • 125I-Angiotensin II binding to human blood cells.

    abstract::The binding of 125I-angiotensin II to human blood cells was investigated. Blood was drawn from healthy volunteers and platelets prepared with minimal contamination of red cells and white blood cells (less than 0.1%). Using thin layer chromatography, degradation of 125I-angiotensin II by platelets could be demonstrated...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-198504000-00004

    authors: Mann JF,Sis J,Ritz E

    更新日期:1985-04-01 00:00:00

  • The vascular response to vasodilators is related to the membrane content of polyunsaturated fatty acids in hypertensive patients.

    abstract:OBJECTIVE:Abnormal vascular reactivity contributes to the pathophysiology of hypertension and hypertension-related organ damage. As the dietary content of fatty acids may affect the vascular responses, we investigated the relationship of endothelium-independent and endothelium-dependent vasodilation with the fatty acid...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0000000000000495

    authors: Colussi G,Catena C,Dialti V,Mos L,Sechi LA

    更新日期:2015-05-01 00:00:00

  • Does home blood pressure allow for a better assessment of the white-coat effect than ambulatory blood pressure?

    abstract:BACKGROUND:The difference between clinic and ambulatory blood pressure (BP) is a poor estimate of the true white-coat effect (WCE) measured with beat-to-beat recording. METHOD:We investigated whether the difference between clinic and home BP (home WCE) was a better estimate of true WCE than ambulatory WCE. In 73 young...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/HJH.0b013e3283589ee6

    authors: Saladini F,Benetti E,Malipiero G,Casiglia E,Palatini P

    更新日期:2012-11-01 00:00:00

  • Plasma human atrial natriuretic peptide, endothelin-1, aldosterone and plasma-renin activity in pregnancy-induced hypertension.

    abstract:OBJECTIVE:To determine the relationship between endothelin-1 (ET-1), human atrial natriuretic peptide (hANP), plasma-renin activity (PRA) and 24-h urinary excretion of aldosterone (U-Ald) in pregnancy-induced hypertension (PIH). DESIGN AND METHODS:Plasma hANP (pg/ml), ET-1 (pg/ml), PRA (ng/ml per h) and U-Ald (microg/...

    journal_title:Journal of hypertension

    pub_type: 临床试验,杂志文章

    doi:10.1097/00004872-199917090-00012

    authors: Zafirovska KG,Maleska VT,Bogdanovska SV,Lozance LA,Masin-Paneva J,Gerasimovska BD

    更新日期:1999-09-01 00:00:00

  • A double-blind evaluation of captopril in elderly hypertensives.

    abstract::To establish the role of angiotensin converting enzyme inhibitors in the management of hypertension in the elderly, 16 patients were treated with captopril in a randomized double-blind placebo-controlled cross-over study. Clinic blood pressure, ambulatory blood pressure, renal function and mental performance, with emp...

    journal_title:Journal of hypertension

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Cox JP,Duggan J,O'Boyle CA,Mee F,Walsh JB,Coakley D,O'Brien E,O'Malley K

    更新日期:1989-04-01 00:00:00

  • A method of quantifying retinal microvascular alterations associated with blood pressure and age.

    abstract:OBJECTIVE:To find an objective, sensitive method for quantifying microvascular alterations associated with level of blood pressure and age. DESIGN:A prospective cross-sectional study. SUBJECTS AND METHODS:Seventy-four previously untreated hypertensive patients, referred to a hospital outpatients department, and 26 no...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:

    authors: Stanton AV,Mullaney P,Mee F,O'Brien ET,O'Malley K

    更新日期:1995-01-01 00:00:00

  • Na+,K+,Cl- cotransport is a marker of distal tubular function in essential hypertension.

    abstract:OBJECTIVE:To analyze the natriuretic and diuretic response to frusemide in 33 male essential hypertensive patients as a function of basal renal sodium handling and erythrocyte transport system. METHODS:The natriuretic and diuretic response to an oral dose of frusemide (25 mg) was assessed with a simplified method. Uri...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:

    authors: Righetti M,Cusi D,Stella P,Rivera R,Bernardi L,del Vecchio L,Bianchi G

    更新日期:1995-12-01 00:00:00

  • Different effects of low and high doses of endothelin on haemodynamics and hormones in the normotensive conscious dog.

    abstract::The effects of low-dose endothelin on systemic haemodynamics and vasoactive hormones were examined in conscious dogs. In addition, we examined the effects of endothelin on pressor responses to noradrenaline and angiotensin II and the baroreflex regulation of heart rate in conscious dogs. Continuous infusion of 40 fmol...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-199104000-00005

    authors: Nakamoto H,Suzuki H,Murakami M,Kageyama Y,Naitoh M,Sakamaki Y,Ohishi A,Saruta T

    更新日期:1991-04-01 00:00:00

  • Role of angiotensin II in hyperinsulinemia-induced hypertension in rats.

    abstract:OBJECTIVE:To investigate the role of angiotensin II in the pathogenesis of hyperinsulinemia-induced hypertension in rats. MATERIALS AND METHODS:Chronic hyperinsulinemia was achieved by infusing insulin (3 mU/kg per min) subcutaneously by an osmotic minipump for 6 weeks. An angiotensin converting enzyme inhibitor (fosi...

    journal_title:Journal of hypertension

    pub_type: 杂志文章

    doi:10.1097/00004872-199816120-00009

    authors: Fang TC,Huang WC

    更新日期:1998-12-01 00:00:00