ArticleJournal of stroke2019
Association of Elevated Blood Pressure Levels with Outcomes in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis: A Systematic Review and Meta-Analysis.
Article in Journal of stroke, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Relationship between blood pressure level with prognosis of acute ischemic stroke patients treated with intravenous thrombolysis: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- 2025 update to European Stroke Organisation (ESO) guideline on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage.European stroke journal · 2026Guideline
- Prognostic significance of early systolic blood pressure variability after endovascular thrombectomy and intravenous thrombolysis in acute ischemic stroke: A systematic review and meta-analysis.Brain and behavior · 2020Pooled it
- Association of Blood Pressure With Outcomes in Acute Stroke Thrombectomy.Hypertension (Dallas, Tex. : 1979) · 2020Pooled it
- Medical Management vs Mechanical Thrombectomy for Mild Strokes: An International Multicenter Study and Systematic Review and Meta-analysis.JAMA neurology · 2020Pooled it
- Clevidipine infusion for blood pressure management after successful revascularisation in acute ischaemic stroke: the CLEVER study.European stroke journal · 2026Trial
- Cerebral hemodynamics in stroke thrombolysis (CHiST) study.PloS one · 2020Trial
- Discontinuation of intravenous thrombolysis in acute ischemic stroke.BMC neurology · 2026Article
- Blood Pressure Management in Neurologic Emergencies.Emergency medicine clinics of North America · 2026Review
- Development of a nomogram prediction model for thrombolytic outcomes in acute ischemic stroke.BMC neurology · 2025Article
- Blood Pressure Management Pre- and Post-Reperfusion in Acute Ischemic Stroke: Evidence and Insights from Recent Studies.Current neurology and neuroscience reports · 2025Review
- Association of reverse dipping blood pressure with mortality among critically ill patients with ischemic stroke.Internal and emergency medicine · 2025Article
- Blood pressure management in reperfused ischemic stroke.The Cochrane database of systematic reviews · 2025Article
- Association of Early Blood Pressure Levels and Outcomes in Ischemic Stroke Treated With Intravenous Thrombolysis: A Prospective Cohort Study.CNS neuroscience & therapeutics · 2025Observational
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- Blood Pressure Management Following Endovascular Stroke Treatment: A Feasibility Trial and Meta-Analysis of Outcomes.Stroke (Hoboken, N.J.) · 2024Article
- Blood Pressure Variability in Acute Stroke: A Narrative Review.Journal of clinical medicine · 2024Review
- Association of the Neutrophil-to-Lymphocyte Ratio with 90-Day Functional Outcomes in Patients with Acute Ischemic Stroke.Brain sciences · 2024Article
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Association between blood pressure and endovascular treatment outcomes differs by baseline perfusion and reperfusion status.Scientific reports · 2023Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAlthough arbitrary blood pressure (BP) thresholds exist for acute ischemic stroke (AIS) patients eligible for intravenous thrombolysis (IVT), current international recommendations lack clarity on the impact of mean pre- and post-IVT BP levels on clinical outcomes.
methodsEligible studies involving IVT-treated AIS patients were identified that reported the association of mean systolic BP (SBP) or diastolic BP levels before and after IVT with the following outcomes: 3-month favorable functional outcome (modified Rankin Scale [mRS] scores of 0-1) and 3-month functional independence (mRS scores of 0-2), 3-month mortality and symptomatic intracranial hemorrhage (sICH). Unadjusted analyses of standardized mean differences and adjusted analyses of studies reporting odds ratios (ORadj) per 10 mm Hg BP increment were performed using random-effects models.
resultsWe identified 26 studies comprising 56,513 patients. Higher pre- (P=0.02) and posttreatment (P=0.006) SBP levels were observed in patients with sICH. Patients with 3-month functional independence had lower post-treatment (P<0.001) SBP whereas trended towards lower pre-treatment (P=0.06) SBP. In adjusted analyses, elevated pre- (ORadj, 1.08; 95% confidence interval [CI], 1.01 to 1.16) and post-treatment (ORadj, 1.13; 95% CI, 1.01 to 1.25) SBP levels were associated with increased likelihood of sICH. Increasing pre- (ORadj, 0.91; 95% CI, 0.84 to 0.98) and post-treatment (ORadj, 0.70; 95% CI, 0.57 to 0.87) SBP values were also related to lower odds of 3-month functional independence.
conclusions We found that elevated BP levels adversely impact AIS outcomes in patients receiving IVT. Future randomized-controlled clinical trials will provide definitive data on the aforementioned association.
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