What is Emergency Medicine - How should I handle hypertension in a patient who has recently suffered an ischemic stroke?
Reduced vascular damage is a benefit of lowering blood pressure, but again, higher than average blood pressures could be required to achieve the best brain perfusion. If the patient has another comorbid condition that might benefit from reduced blood pressure, or if their systolic or diastolic blood pressure is less than 220 or 120 mmHg, the AHA recommendations advise gradually lowering their blood pressure by 15%. (e.g., heart failure, dissection, pre-eclampsia). However, within the first 24 hours after receiving tPA, the patient's blood pressure needs to be kept at 180/105.
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