Recent research shows that early identification of the style of stroke could also be key to realizing the advantages of very early use of blood pressure-lowering treatment within the ambulance for patients suspected of getting an acute stroke.

The outcomes were presented on the tenth edition^vol European Stroke Organization Conference in Basel, Switzerland and published concurrently within the journal Recent England Journal of Medicine.

Professor Craig Anderson, director of Global Brain Health on the George Institute for Global Health and principal investigator of the study, said that while more research was needed, the outcomes led to improved outcomes for patients with the deadliest style of stroke.

“Our study shows a transparent advantage of providing early blood pressure-lowering treatment to patients with intracerebral hemorrhage within the ambulance, although overall there was no difference within the outcomes of this early intervention for all patients with suspected stroke.

“In reality, for patients who were ultimately diagnosed with ischemic stroke, it actually worsened their prognosis, so the flexibility to make a reliable diagnosis at this early stage is essential to realizing the advantages of very early blood pressure treatment.”

The Intensive Ambulance Blood Pressure Lowering for Hyperacute Stroke (INTERACT4) trial was a multicenter, randomized, open-label, blinded trial conducted in dozens of ambulance services in China.

2,404 emergency room patients with suspected acute stroke causing motor deficits inside two hours of onset and elevated systolic blood pressure (≥150 mmHg) were randomized to immediate lowering blood pressure (goal 130–140 mmHg) or normal blood pressure (BP). hospital management.

Within the hemorrhagic stroke group who received prehospital emergency BP reduction, the probability of poor functional end result was 30% lower, whereas within the cerebral ischemia group the probability of poor functional end result was 30% higher compared with patients with this stroke. types who received standard BP care upon arrival on the hospital.

Overall, the consequences of prehospital blood pressure lowering showed a balanced effect of advantages and harms, such that there was no overall difference in functional outcomes between patients who received usual care amongst all stroke patients. The incidence of significant opposed events was similar between groups.

About 80 percent of strokes worldwide are ischemic, attributable to lack of blood flow to an area of ​​the brain on account of a blocked blood vessel, resulting in lack of neurological function.​​​​​

Intracerebral hemorrhage (ICH) accounts for greater than 1 / 4 of all stroke cases and occurs when blood leaks from a blood vessel into the brain tissue. ICH is the deadliest style of stroke, leading to as many as one-third of patients dying inside 30 days. It’s more common in China, where the study was conducted.

All treatments for acute stroke are highly time-sensitive – brain cells die quickly once they are deprived of oxygen. Nevertheless, knowing the most effective treatment approach before determining the style of stroke a patient has experienced is difficult without brain imaging.”

Professor Craig Anderson, Director of Global Brain Health, The George Institute for Global Health

“The outcomes don’t support using blood pressure-lowering treatment within the ambulance in patients suspected of acute stroke – that is clear.

“Nevertheless, over the previous couple of years we’ve got seen the introduction of mobile stroke ambulances equipped with CT scans and other diagnostic tools that aim to discover cases of ischemic stroke so as to provide early clot-busting treatment.

“But our results confirm that ambulance treatment also needs to be utilized in patients with hemorrhagic stroke.

“Within the meantime, while acute stroke treatment takes place within the hospital, faster diagnosis and quick motion once a patient arrives on the emergency department is crucial to preserving brain function.”