Popa G, Jipescu I
Institute of Neurology and Psychiatry, Bucharest, Romania.
Rom J Neurol Psychiatry. 1994 Jul-Sep;32(3):135-40.
The reasons for not treating hypertension could be the risk of reducing cerebral blood flow (CBF) which may induce additional cerebral damage in the so-called ischaemic "penumbra". Hypertensive patients have altered autoregulation. A severe hypertension (over 230/120 mmHg) may lead to further damage by cerebral edema which asks for antihypertensive therapy. An antihypertensive therapy was applied in 81 patients within the 72 hours interval from acute ischaemic stroke (AIS) onset. In 42 patients, the antihypertensive treatment was discontinued after the 72-hour interval (the therapy with nifedipine in daily doses of 10-20 mg was not considered as hypotensive). We compared as end points: the survival, death, modified Rankin Scale (mRS). There were no statistically significant differences between end points of patients who discontinued (group C) and those who maintained (group T) the antihypertensive therapy. The mean value of blood pressure was higher in patients who maintained antihypertensive therapy (p < 0.001 for systolic blood pressure (BP); p = 0.001593 for diastolic blood pressure). The mean value of age in patients in whom antihypertensive therapy was discontinued was higher than that found in patients who maintained antihypertensive therapy (p < 0.05).
不治疗高血压的原因可能是存在降低脑血流量（CBF）的风险，这可能会在所谓的缺血“半暗带”中导致额外的脑损伤。高血压患者的自动调节功能发生了改变。严重高血压（超过230/120 mmHg）可能会因脑水肿导致进一步损伤，这就需要进行抗高血压治疗。在急性缺血性卒中（AIS）发病后的72小时内，对81例患者进行了抗高血压治疗。在42例患者中，72小时后停止了抗高血压治疗（每日剂量为10 - 20 mg的硝苯地平治疗不被视为降压治疗）。我们将生存、死亡、改良Rankin量表（mRS）作为终点进行比较。停止抗高血压治疗的患者（C组）和维持抗高血压治疗的患者（T组）的终点之间没有统计学上的显著差异。维持抗高血压治疗的患者的血压平均值更高（收缩压（BP）p < 0.001；舒张压p = 0.001593）。停止抗高血压治疗的患者的平均年龄高于维持抗高血压治疗的患者（p < 0.05）。
