New findings for stroke treatment

Disability rates can be lowered in stroke patients if their blood pressure is acutely lowered and smoothed out at low levels for sustained periods, Australian researchers have found. More than one million people suffer from stroke each year, with death or disability the usual outcomes.

The research findings, led by Professor Craig Anderson of The George Institute and The University of Sydney, come off the back of breakthrough findings last year that are in the process of changing stroke patient treatment worldwide.

That research found improved outcomes for stroke patients who received early, intensive treatment to lower their blood pressure.

The newest research, published in The Lancet today, assessed the clinical significance of blood pressure in the first 24 hours, and during days two to seven in patients following intracerebral haemorrhage.

“We found that the greater the variation in blood pressure within the first week, the more likely it is the patient will die or suffer major disability,” said Professor Anderson.

“Our findings suggest that it is important not only to rapidly and immediately reduce blood pressure in stroke patients, but also to ensure blood pressure control is smooth and sustained for several days.

“Clinicians should not be falsely reassured by the presence of a few normal blood pressure readings in patients whose systolic blood pressure is fluctuating widely or is often high. Blood pressure monitoring should be frequent throughout the patient’s stay in hospital.”

Professor Anderson said the research findings were significant not just because they indicated that current treatment methods should change, but also because they indicated that fluctuating blood pressure, or episodic hypertension, plays a significant role in the patient’s outcome as well as a role in the triggering of a brain haemorrhage stroke.

Dr Erin Lalor, CEO of the National Stroke Foundation, said: “Treatment breakthroughs such as this could have a huge impact on the quality of life of stroke survivors following hospitalisation.

“Stroke is a leading cause of disability in Australia and changes people’s lives suddenly and dramatically. We welcome any research that can help reduce the impact of stroke on survivors and help them get back home and living independently.”

Professor Anderson will present his study today at the world’s most important stroke conference, the International Stroke Conference in San Diego, the United States.

He and his team are currently seeking funding to start a project to change the way stroke patients are treated in hospital.

“We generate the evidence, but it’s up to other people to implement that evidence. And it is imperative that treatment has to change, because changing treatment will improve outcomes for stroke patients. Our study has shown fewer die, and disability is not so severe.”