{"title":"Prehospital blood pressure lowering in patients with ischemic stroke: A systematic review and meta-analysis of randomized controlled trials.","authors":"Xiang Yuan, Qi Gan, Yu Zhang, Peng Wang, Weelic Chong, Yang Hai, Fang Fang","doi":"10.1177/17474930241298445","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Whether prehospital blood pressure control improves outcomes among patients with acute ischemic stroke is uncertain. This systematic review and meta-analysis aimed to evaluate the effect of prehospital blood pressure reduction treatment in patients with ischemic stroke.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials that compared prehospital blood pressure reduction treatment with usual treatment or no treatment in patients with stroke. The primary outcome was functional outcome, assessed with the distribution of modified Rankin Scale (mRS) at 90 days, while secondary outcome was mortality at 90 days.</p><p><strong>Results: </strong>Of 428 studies reviewed, three were appropriate for analysis, totaling 3878 patients. In patients with ischemic stroke, prehospital blood pressure reduction treatment was associated with higher mRS scores at 90 days (common odds ratio (OR) for worse mRS, OR: 1.27, 95% confidence interval (CI): 1.08-1.49) and increased risk of mortality at 90 days (OR: 1.28, 95% CI: 1.02-1.61) compared with the usual treatment.</p><p><strong>Conclusion: </strong>In patients with ischemic stroke, prehospital blood pressure reduction treatment was associated with a higher likelihood of poor functional outcome and an elevated risk of mortality.</p>","PeriodicalId":14442,"journal":{"name":"International Journal of Stroke","volume":" ","pages":"17474930241298445"},"PeriodicalIF":6.3000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17474930241298445","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Whether prehospital blood pressure control improves outcomes among patients with acute ischemic stroke is uncertain. This systematic review and meta-analysis aimed to evaluate the effect of prehospital blood pressure reduction treatment in patients with ischemic stroke.
Methods: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials that compared prehospital blood pressure reduction treatment with usual treatment or no treatment in patients with stroke. The primary outcome was functional outcome, assessed with the distribution of modified Rankin Scale (mRS) at 90 days, while secondary outcome was mortality at 90 days.
Results: Of 428 studies reviewed, three were appropriate for analysis, totaling 3878 patients. In patients with ischemic stroke, prehospital blood pressure reduction treatment was associated with higher mRS scores at 90 days (common odds ratio (OR) for worse mRS, OR: 1.27, 95% confidence interval (CI): 1.08-1.49) and increased risk of mortality at 90 days (OR: 1.28, 95% CI: 1.02-1.61) compared with the usual treatment.
Conclusion: In patients with ischemic stroke, prehospital blood pressure reduction treatment was associated with a higher likelihood of poor functional outcome and an elevated risk of mortality.
期刊介绍:
The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.