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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author Yuyang Liu
Yaheng Tan
Jun Wan
Yangchun Xiao
Qiwen Chen
Yuxin Zheng
Chengli Tian
Xinyue Wang
Wenhao Xu
Xueying Yu
Dianxiang Lu
author_facet Yuyang Liu
Yaheng Tan
Jun Wan
Yangchun Xiao
Qiwen Chen
Yuxin Zheng
Chengli Tian
Xinyue Wang
Wenhao Xu
Xueying Yu
Dianxiang Lu
author_sort Yuyang Liu
collection DOAJ
description <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).
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spelling doaj-art-c72ea8ea9f7e488aab5ad5b585f8bd152025-08-20T03:12:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032649410.1371/journal.pone.0326494Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.Yuyang LiuYaheng TanJun WanYangchun XiaoQiwen ChenYuxin ZhengChengli TianXinyue WangWenhao XuXueying YuDianxiang Lu<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).https://doi.org/10.1371/journal.pone.0326494
spellingShingle Yuyang Liu
Yaheng Tan
Jun Wan
Yangchun Xiao
Qiwen Chen
Yuxin Zheng
Chengli Tian
Xinyue Wang
Wenhao Xu
Xueying Yu
Dianxiang Lu
Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.
PLoS ONE
title Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.
title_full Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.
title_fullStr Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.
title_full_unstemmed Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.
title_short Prehospital blood pressure lowering in patients with ultra-acute presumed stroke: A systematic review and meta-analysis.
title_sort prehospital blood pressure lowering in patients with ultra acute presumed stroke a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0326494
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