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Treatment of Post-Stroke Hypertension

A Practical Guide

  • Review Article
  • Disease Management
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Summary

Cerebrovascular disease is a common cause of morbidity and mortality, especially in the elderly. Treatment of hypertension is effective in the primary prevention of stroke. Hypertension is seen in 80% of acute stroke patients but, by the tenth day after admission to hospital, only one-third are still hypertensive.

The clinical significance of post-stroke hypertension is uncertain and its management is a contentious issue. In this article we review current evidence regarding the risks and benefits of the treatment of post-stroke hypertension.

The pathophysiology of post-stroke hypertension is described in relation to autoregulation of cerebral blood flow after cerebral infarction or haemorrhage. In the absence of clinical trial data, recommendations for early treatment of post-stroke hypertension are based on a review of expert opinion that immediate, controlled lowering of blood pressure after acute stroke is required only in defined situations such as hypertensive encephalopathy or aortic dissection. There are no reliable data regarding the comparative effects of different hypotensive agents after acute stroke; short-acting vasodilator drugs are recommended if treatment is essential.

The benefits of hypotensive therapy in secondary prevention of recurrent stroke are uncertain but the results of large clinical trials in progress should provide helpful guidelines for clinical practice.

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Authors and Affiliations

  1. South Tyneside District Hospital, South Shields, Tyne and Wear, NE34 0PL, England

    Janice E. O’Connell (Elderly Care Directorate)

  2. Queen Elizabeth Hospital, Gateshead, Tyne and Wear, England

    Christopher S. Gray

Authors
  1. Janice E. O’Connell
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  2. Christopher S. Gray
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O’Connell, J.E., Gray, C.S. Treatment of Post-Stroke Hypertension. Drugs & Aging 8, 408–415 (1996). https://doi.org/10.2165/00002512-199608060-00002

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