?? Paper of the day

?? Intensive vs Conventional BP management after Endovascular Thrombectomy

Published in JAMA

https://jamanetwork.com/journals/jama/fullarticle/2808993?guestAccessKey=7cf4b3ae-f9d8-43da-a3e3-ef667427602d&utm_source=silverchair&utm_campaign=jama_network&utm_content=neu_weekly_highlights&utm_medium=email&adv=000002318188

??Summary

This article discusses a randomized clinical trial called the OPTIMAL-BP trial, which aimed to determine whether intensive blood pressure management improves outcomes after successful reperfusion with endovascular thrombectomy in acute ischemic stroke. The trial included 306 patients.

?? Takeaways:

1?? The study showed that 39.4% of patients with intensive BP management (systolic blood pressure target <140 mm Hg) achieved functional independence at 3 months, compared to 54.4% of those with conventional blood pressure management (systolic blood pressure target 140-180 mm Hg).

2?? The results suggest that intensive blood pressure lowering after successful reperfusion may not lead to better clinical outcomes and may even be harmful.

3. The study highlights the need for further research to determine the optimal target for blood pressure control in stroke patients with successful reperfusion following endovascular thrombectomy.

?? Limitations:

1. Some may argue that the study sample size was relatively small, which could limit the generalizability of the findings.

2. Others may argue that individual patient characteristics and comorbidities could influence the impact of intensive blood pressure management, and further studies should consider these factors.

3. It is important to note that this study focused specifically on patients who underwent endovascular thrombectomy, and the findings may not apply to all acute ischemic stroke patients.