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Post-stroke therapy is dangerous

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A standard treatment for stroke patients is dangerous and should be stopped immediately, researchers are saying.

Doctors are trained to aggressively lower blood pressure levels after dissolving the blood clots in the brain that caused the stroke, but it’s a therapy that is causing major disability and killing new brain tissue.

Although it has become standard treatment, it’s never been tested against a more conservative approach—until now.  Researchers from the George Institute for Global Health in Australia measured the affects of the therapy—which aims to reduce blood pressure levels to below 120 mm Hg—against a more conservative approach, which looked to reduce levels to between 140 and 180 mm Hg.

They recruited 816 people who had suffered an ischaemic stroke—caused by the loss of blood flow to the brain because of a blood vessel blockage—and 407 had the standard, aggressive treatment, and the rest had the more moderate approach.  The aim was to achieve the new blood pressure reading within an hour and sustain it for three days.

Those given the more aggressive treatment suffered major disability and weren’t seeing any physical improvements in their movements after the stroke. 

The aggressive treatment is used after clots in the brain have been dispersed, and is based on the theory that a rapid return of blood supply to the brain after it has been deprived of oxygen can cause tissue damage, known as reperfusion injury.

But trying to attain ‘healthy’ levels is unnecessary and causes further damage, the researchers say.

While the research has demonstrated that it is not essential to reduce blood pressure to such a low level, the researchers say they don’t know what the optimum level should be following stroke.

The Lancet, 2022; doi: 10.1016/S0140-6736(22)01882-7

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