Van Matre Edward T, Cook Aaron M, Shah Samarth P, Rydz Alexandria C, Smetana Keaton S
Department of Clinical Pharmacy and Translational Science, University of Tennessee College of Pharmacy, Memphis (Dr Van Matre); Pharmacy Services, University of Kentucky HealthCare, Lexington (Dr Cook); Department of Pharmacy, Methodist University Hospital, Memphis, Tennessee (Dr Shah); and Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus (Drs Rydz and Smetana).
Crit Care Nurs Q. 2019 Apr/Jun;42(2):148-164. doi: 10.1097/CNQ.0000000000000248.
Acute blood pressure control after a cerebrovascular event is integral in the immediate care of these patients to preserve perfusion to ischemic areas and prevent intracerebral bleeding. The majority of patients with ischemic stroke or intracerebral hemorrhage (ICH) present with preexisting hypertension and therefore require a treatment plan after the acute phase. The presence of chronic hypertension after ICH has often been discussed as a modifiable risk factor for recurrent events. Clinical evidence is relatively lacking for clinicians to understand the extent of blood pressure lowering and the optimal agents to use in this setting. Limited data exist describing the long-term management of hypertension in patients after cerebrovascular events. This review provides nurses with a summary of the available literature on long-term blood pressure management to minimize the risk of secondary ICH and ischemic stroke. It focuses on oral antihypertensive medications available in the United States that may be utilized to manage chronic hypertension immediately after the postacute phase of care to lower blood pressure and to improve long-term outcomes.
脑血管事件后的急性血压控制对于这些患者的即时护理至关重要，以维持对缺血区域的灌注并预防脑出血。大多数缺血性中风或脑出血（ICH）患者存在既往高血压，因此在急性期后需要一个治疗方案。脑出血后慢性高血压的存在常被视为复发事件的一个可改变的危险因素。临床证据相对缺乏，临床医生难以了解血压降低的程度以及在此情况下使用的最佳药物。关于脑血管事件后患者高血压长期管理的数据有限。本综述为护士提供了关于长期血压管理的现有文献总结，以尽量降低继发性脑出血和缺血性中风的风险。它重点关注美国可用的口服抗高血压药物，这些药物可用于在护理的急性期后立即管理慢性高血压，以降低血压并改善长期预后。
