Nav: Home

Intensive blood pressure lowering safe for clot-buster-treated stroke patients, but...

February 07, 2019

HONOLULU, Feb. 7, 2019 -- Intensive blood pressure lowering safely reduced the risk of bleeding in the brain in ischemic stroke patients being treated with clot-busting drugs, but did not improve post-stroke recovery, according to late breaking science presented at the American Stroke Association's International Stroke Conference 2019, a world premier meeting for researchers and clinicians dedicated to the science and treatment of cerebrovascular disease.

The large international clinical trial, Enhanced Control of Hypertension and Thrombolysis Stroke (ENCHANTED) study will be simultaneously published in The Lancet.

Bleeding in the brain can be a major side effect of clot-busting stroke treatment. While more intensive blood pressure lowering has been suggested to decrease bleeding risk, there have been longstanding concerns that this additional treatment could worsen the stroke damage in the brain, according to co-lead investigator Craig Anderson, M.D., Ph.D., professor of Neurology and Epidemiology at the University of New South Wales in Sydney, Australia and executive director of The George Institute in China.

Researchers investigated whether intensive lowering of systolic blood pressure (the top number in a blood pressure reading) to less than 140 millimeters of mercury (mm Hg) could lessen post-stroke disability and could safely reduce the risk of bleeding in the brain better than lowering systolic blood pressure to the standard recommended target of less than 180 mm Hg over three days.

More than 2,000 patients (average age 67, 38 percent women) from 110 hospitals in 15 countries were treated between 2013 and 2018.

Researchers found:
    * The level of disability at 90 days did not differ between patients receiving intensive or standard blood pressure management.

    * Significantly fewer patients had bleeding within the brain after intensive compared to standard blood pressure management.

    * Large and serious bleeding in the brain were lower with intensive blood pressure lowering.

    * No harm was identified for intensive blood pressure management.
Researcher said the results were influenced by the difference in blood pressure management between the patient groups being less than planned, with many patients in the standard treatment group receiving more blood pressure management lowering than typically used in clinical practice.

"This study clearly shows intensive blood pressure lowering has the potential to make thrombolysis treatment safer, by reducing the risk of serious bleeding in the brain," Anderson said.

More research is required to better understand why the reduced risk of bleeding in the brain did not translate into improved overall outcome for patients.

"These findings also highlight the need for more research to better understand the underlying mechanisms of benefit and harm of early intensive blood pressure lowering in the patients receiving modern reperfusion therapy with thrombolysis and devices, given that the reduction in brain hemorrhage failed to translate into improvements in overall recovery for patients," added Professor Tom Robinson, co-lead investigator and head of the Cardiovascular Research Centre at the University of Leicester, United Kingdom.

Other co-authors are listed on the abstract.
-end-
The National Health and Medical Research Council (NHMRC) of Australia and the UK Stroke Association and others funded the research.

Note: Scientific presentation is 11:24 a.m. Hawaii Time/4:24 p.m. Eastern Time, Thursday, Feb. 7, 2019.

Additional Resources:

* VIDEO: Miguel Perez-Pinzon, Ph.D., FAHA, Chair, International Stroke Conference 2019 Program Committee, offers overviews and perspective on late breaking science via downloadable Skype video (transcript provided) available on the right column of the release link https://newsroom.heart.org/news/intensive-blood-pressure-lowering-safe-for-clot-buster-treated-stroke-patients-but-doesnt-lessen-disability?preview=53762ea3054b14705382700bd75788e8

* Stroke Treatment

* For more news from AHA International Stroke Conference 2019, follow us on Twitter @HeartNews #ISC19.

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke -- the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit StrokeAssociation.org. Follow us on Facebook and Twitter.

American Heart Association

Related Brain Articles:

Transplanting human nerve cells into a mouse brain reveals how they wire into brain circuits
A team of researchers led by Pierre Vanderhaeghen and Vincent Bonin (VIB-KU Leuven, Université libre de Bruxelles and NERF) showed how human nerve cells can develop at their own pace, and form highly precise connections with the surrounding mouse brain cells.
Brain scans reveal how the human brain compensates when one hemisphere is removed
Researchers studying six adults who had one of their brain hemispheres removed during childhood to reduce epileptic seizures found that the remaining half of the brain formed unusually strong connections between different functional brain networks, which potentially help the body to function as if the brain were intact.
Alcohol byproduct contributes to brain chemistry changes in specific brain regions
Study of mouse models provides clear implications for new targets to treat alcohol use disorder and fetal alcohol syndrome.
Scientists predict the areas of the brain to stimulate transitions between different brain states
Using a computer model of the brain, Gustavo Deco, director of the Center for Brain and Cognition, and Josephine Cruzat, a member of his team, together with a group of international collaborators, have developed an innovative method published in Proceedings of the National Academy of Sciences on Sept.
BRAIN Initiative tool may transform how scientists study brain structure and function
Researchers have developed a high-tech support system that can keep a large mammalian brain from rapidly decomposing in the hours after death, enabling study of certain molecular and cellular functions.
Wiring diagram of the brain provides a clearer picture of brain scan data
In a study published today in the journal BRAIN, neuroscientists led by Michael D.
Blue Brain Project releases first-ever digital 3D brain cell atlas
The Blue Brain Cell Atlas is like ''going from hand-drawn maps to Google Earth'' -- providing previously unavailable information on major cell types, numbers and positions in all 737 brain regions.
Landmark study reveals no benefit to costly and risky brain cooling after brain injury
A landmark study, led by Monash University researchers, has definitively found that the practice of cooling the body and brain in patients who have recently received a severe traumatic brain injury, has no impact on the patient's long-term outcome.
Brain cells called astrocytes have unexpected role in brain 'plasticity'
Researchers from the Salk Institute have shown that astrocytes -- long-overlooked supportive cells in the brain -- help to enable the brain's plasticity, a new role for astrocytes that was not previously known.
Largest brain study of 62,454 scans identifies drivers of brain aging
In the largest known brain imaging study, scientists from Amen Clinics (Costa Mesa, CA), Google, John's Hopkins University, University of California, Los Angeles and the University of California, San Francisco evaluated 62,454 brain SPECT (single photon emission computed tomography) scans of more than 30,000 individuals from 9 months old to 105 years of age to investigate factors that accelerate brain aging.
More Brain News and Brain Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 3: Shared Immunity
More than a million people have caught Covid-19, and tens of thousands have died. But thousands more have survived and recovered. A week or so ago (aka, what feels like ten years in corona time) producer Molly Webster learned that many of those survivors possess a kind of superpower: antibodies trained to fight the virus. Not only that, they might be able to pass this power on to the people who are sick with corona, and still in the fight. Today we have the story of an experimental treatment that's popping up all over the country: convalescent plasma transfusion, a century-old procedure that some say may become one of our best weapons against this devastating, new disease.   If you have recovered from Covid-19 and want to donate plasma, national and local donation registries are gearing up to collect blood.  To sign up with the American Red Cross, a national organization that works in local communities, head here.  To find out more about the The National COVID-19 Convalescent Plasma Project, which we spoke about in our episode, including information on clinical trials or plasma donation projects in your community, go here.  And if you are in the greater New York City area, and want to donate convalescent plasma, head over to the New York Blood Center to sign up. Or, register with specific NYC hospitals here.   If you are sick with Covid-19, and are interested in participating in a clinical trial, or are looking for a plasma donor match, check in with your local hospital, university, or blood center for more; you can also find more information on trials at The National COVID-19 Convalescent Plasma Project. And lastly, Tatiana Prowell's tweet that tipped us off is here. This episode was reported by Molly Webster and produced by Pat Walters. Special thanks to Drs. Evan Bloch and Tim Byun, as well as the Albert Einstein College of Medicine.  Support Radiolab today at Radiolab.org/donate.