Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.

<h4>Objective</h4>High blood pressure frequently occurs in the setting of acute stroke and is associated with worse prognoses. However, it is still uncertain whether initiating blood pressure-lowering therapy in the prehospital phase after stroke onset can enhance outcomes for patients w...

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Main Authors: Yuyang Liu, Yaheng Tan, Jun Wan, Yangchun Xiao, Qiwen Chen, Yuxin Zheng, Chengli Tian, Xinyue Wang, Wenhao Xu, Xueying Yu, Dianxiang Lu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0326494
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Summary:<h4>Objective</h4>High blood pressure frequently occurs in the setting of acute stroke and is associated with worse prognoses. However, it is still uncertain whether initiating blood pressure-lowering therapy in the prehospital phase after stroke onset can enhance outcomes for patients with undifferentiated acute stroke.<h4>Methods</h4>We conducted a search of the PubMed, Embase, and Cochrane databases to identify randomized controlled trials investigating prehospital blood pressure lowering interventions for presumed ultra-acute stroke (within <6 hours). The primary outcome analyzed was the 90-day modified Rankin Scale (mRS), while mortality was considered a secondary outcome.<h4>Results</h4>This meta-analysis included four studies with a total of 3912 patients. The pooled data revealed no significant difference in poor functional outcomes at 90 days (RR = 0.97, 95% CI: 0.92-1.02) or mortality rates (RR = 1.02, 95% CI: 0.90-1.15) between the group receiving blood pressure lowering treatment and the control or placebo group.<h4>Conclusions</h4>In patients with ultra-acute presumed stroke, prehospital blood pressure lowering treatment within 6 hours of stroke did not improve clinical outcomes (PROSPERO: CRD42024557505).
ISSN:1932-6203