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CONy 2021 | Should blood pressure be lowered in acute stroke?

Csaba Farsang, MD, DSc, St. Imre University Teaching Hospital, Budapest, Hungary, discusses whether blood pressure should be lowered in acute stroke patients. Firstly, Dr Farsang describes contexts where blood pressure must be lowered. These include cases where blood pressure is very high and where patients are receiving numerous interventions: however, stark and abrupt reductions in blood pressure may reduce circulation to the penumbra and worsen stroke. Secondly, Dr Farsang cites European and American guidelines that advise against lowering blood pressure in patients with systolic blood pressures of under 220. Moreover, it is unclear which drugs should be used to reduce blood pressure due to a lack of studies on this topic. Finally, clinical trials investigating which treatments are optimal in reducing blood pressure in acute stroke patients will provide more clarity. This interview was conducted during the virtual 2021 World Congress on Controversies in Neurology (CONy) meeting.