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Internal Medicine • Neurology • Nephrology • Cardiology • Vascular Neurology • Autonomics and Hypertension • Hypertension
How do you approach long-term blood pressure parameters in ischemic stroke patients with severe symptomatic intracranial stenosis?
How do you balance between having a higher long-term blood pressure to prevent flow failure and leading to worsening of stenosis or occlusion from the elevated blood pressure?
Answer from: at Community Practice
Every patient is unique and I just try to be as low and slow as possible. 4-6 weeks seems to be where most people do well with others tolerating more (I'm able to get them to under 140 or even 120 during their hospitalization over a few days). In the acute setting, I've found it helpful to make sure...
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Answer from: at Academic Institution
If a higher blood pressure range is required to control the patient's TIA symptoms, I would adjust the BP goal accordingly. If something can be done directly to ameliorate the most severe, symptomatic stenosis, then after the procedure I would return to a usual BP range.