Therapeutic Variation in Lowering Blood Pressure: Effects on Intracranial Pressure in Acute Intracerebral Haemorrhage

Kadicheeni, Meeriam; Robinson, Thompson G.; Divall, Pip; Parry‐Jones, Adrian; Minhas, Jatinder S.

doi:10.1007/s40292-021-00435-z

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…From a review study, CCB was the most common antihypertensive medication [ 31 ]. CCB is an effective and safe antihypertensive medication for any age, especially old people [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Self-Monitoring Home Blood Pressure in Community-Dwelling Older People: Age Differences in White-Coat and Masked Phenomena and Related Factors—The SONIC Study

Tuo

Godai

Kabayama

et al. 2022

International Journal of Hypertension

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Some studies reported that home blood pressure (HBP) monitoring was conducted by community-dwelling older people themselves, but there have been few studies on HBP including very old populations aged over 90 years old. Thus, the aim of the present study was to clarify the current situation of white-coat and masked phenomena defined by on-site and home BP measurements in community-dwelling old and oldest-old populations. The study subjects were 380 participants from the SONIC study, a cohort study of a community-dwelling old population, who measured their HBP in a series of 3–5 days by themselves and brought their HBP records to the venue on the survey day. Study participants’ characteristics were as follows: female, 185 (48.7%); male, 195 (51.3%); 70s, 95 (25.0%); 80s, 245 (64.5%); and 90s, 40 (10.5%). A total of 344 (90.5%) participants had hypertension. A total of 291 (76.6%) hypertensive participants taking antihypertensive medication were analyzed in the present study. Regarding the types of hypertension defined by home and on-site BP, they showed white-coat phenomenon, 183 (48.2%); masked phenomenon, 115 (30.3%); sustained hypertension, 130 (34.2%); and normotension, 82 (21.6%). On comparison of age groups, there was a tendency for the white-coat phenomenon to be common in young-old people in their 70s and the masked phenomenon to be common in very old people in their 90s. Therefore, since the detection of white-coat and masked phenomena is closely associated with appropriate BP management, it is very important for community-dwelling older populations to self-monitor HBP.

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“…From a review study, CCB was the most common antihypertensive medication [ 31 ]. CCB is an effective and safe antihypertensive medication for any age, especially old people [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Self-Monitoring Home Blood Pressure in Community-Dwelling Older People: Age Differences in White-Coat and Masked Phenomena and Related Factors—The SONIC Study

Tuo

Godai

Kabayama

et al. 2022

International Journal of Hypertension

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“…Clearly, larger mechanistic studies are needed. 70 Uncertainty remains as to whether BP lowering benefits the sickest patients after ICH: those with large hematomas (>50 mL) who are at high risk of cerebral hypoperfusion from both the treatment and high ICP, with consequently low CPP. 21 RCTs have failed to include large numbers of such patients, and only smaller mechanistic studies have shown low CPP without attention to interventions such as BP lowering.…”

Section: Bp Lowering In the Context Of Raised Icpmentioning

confidence: 99%

Blood Pressure Management After Intracerebral and Subarachnoid Hemorrhage: The Knowns and Known Unknowns

Minhas

Moullaali

Rinkel

et al. 2022

Stroke

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Blood pressure (BP) elevations often complicate the management of intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage, the most serious forms of acute stroke. Despite consensus on potential benefits of BP lowering in the acute phase of intracerebral hemorrhage, controversies persist over the timing, mechanisms, and approaches to treatment. BP control is even more complex for subarachnoid hemorrhage, where there are rationales for both BP lowering and elevation in reducing the risks of rebleeding and delayed cerebral ischemia, respectively. Efforts to disentangle the evidence has involved detailed exploration of individual patient data from clinical trials through meta-analysis to determine strength and direction of BP change in relation to key outcomes in intracerebral hemorrhage, and which likely also apply to subarachnoid hemorrhage. A wealth of hemodynamic data provides insights into pathophysiological interrelationships of BP and cerebral blood flow. This focused update provides an overview of current evidence, knowledge gaps, and emerging concepts on systemic hemodynamics, cerebral autoregulation and perfusion, to facilitate clinical practice recommendations and future research.

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Cerebral Autoregulation and Neurovascular Coupling in Acute and Chronic Stroke

Beishon

Minhas

2021

Front. Neurol.

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Therapeutic Variation in Lowering Blood Pressure: Effects on Intracranial Pressure in Acute Intracerebral Haemorrhage

Cited by 3 publications

References 36 publications

Self-Monitoring Home Blood Pressure in Community-Dwelling Older People: Age Differences in White-Coat and Masked Phenomena and Related Factors—The SONIC Study

Self-Monitoring Home Blood Pressure in Community-Dwelling Older People: Age Differences in White-Coat and Masked Phenomena and Related Factors—The SONIC Study

Blood Pressure Management After Intracerebral and Subarachnoid Hemorrhage: The Knowns and Known Unknowns

Cerebral Autoregulation and Neurovascular Coupling in Acute and Chronic Stroke

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