STROKE-ICH, HTN MANAGEMENT

SUMMARY

1. Beware that anti-hypertensive medications can lower cerebral perfusion leading to worsening of the stroke.

2. AHA recommendations for acute HTN management in ischemic stroke, non-thrombolytic candidates: treat if SBP > 220mmHg, DBP > 120mmHg, MAP > 120mmHg.

3. AHA recommendations for HTN management in ischemic stroke, thrombolytic candidates: treat if SBP > 185mmHg, DBP > 110mmHg.

4. HTN management in hemorrhagic stroke is controversial, with frequent practice to treat if SBP > 160mmHg. Agent of choice: IV Labetolol (does not cause cerebral vasodilatation).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].