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Blood Pressure Management - Essay Example

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The following essay under the title "Blood Pressure Management" concerns blood pressure issues. As the author puts it, it has been established that high systolic and Diastolic Blood Pressure (BP) is correlated with risk of stroke. …
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Blood Pressure Management

Download file to see previous pages... The arguments in favor of and against the control of BP were made on the basis of analysis of the above observational studies. It was found that in IS, the BP values return to normal within a short span of IS. Also, lowering of BP during this stage may be detrimental to the rescue of the ischaemic area by treatment as it lowers the perfusion pressure. This is more critical in view of the fact that cerebral autoregulation is dysfunctional under conditions of acute IS and the passive perfusion is completely dependent on the perfusion pressure. Thirdly, the persistent blood pressure may be a required compensation for the occlusion of the blood vessel. However, a large body of data indicates poor outcome in patients with post IS hypertension and is a powerful argument in favor of treatment for lowering of BP. In case of ICH, the BP values spontaneously return to normal within a few days of the episode. Further lowering of BP, in this case, may serve to lower the cerebral perfusion pressure and thus damage the affected brain tissue. However, as in the case of IS, high BP levels have poor correlation with patient recovery and clinical outcome. Thus, patients with elevated ICH values after ICH are associated with death, deterioration, cerebral edema, hematoma and recurrent hemorrhagic stroke. The author goes on to discuss the U shaped relationship, which indicates that either extremely low or high BP values affect clinical outcome adversely. Analysis of data from clinical trials was also done....
It was found that in IS, the BP values return to normal within a short span of IS. Also, lowering of BP during this stage may be detrimental to the rescue of the ischaemic area by treatment as it lowers the perfusion pressure. This is more critical in view of the fact that cerebral autoregulation is dysfunctional under conditions of acute IS and the passive perfusion is completely dependent on the perfusion pressure. Thirdly, the persistent blood pressure may be a required compensation for the occlusion of the blood vessel. However, a large body of data indicates poor outcome in patients with post IS hypertension and is a powerful argument in favor of treatment for lowering of BP.
In case of ICH, the BP values spontaneously return to normal within a few days of the episode. Further lowering of BP in this case may serve to lower the cerebral perfusion pressure and thus damage the affected brain tissue. However, as in the case of IS, high BP levels have poor correlation with patient recovery and clinical outcome. Thus, patients with elevated ICH values after ICH are associated with death, deterioration, cerebral oedema, haematoma and recurrent haemorrhagic stroke. The author goes on to discuss the U shaped relationship, which indicates that either extremely low or high BP values affect clinical outcome adversely.
Analysis of data from clinical trials was also done. The outcome of treatment with several types of antihypertensive drugs in IS has been reviewed. Data from small randomized clinical trials has already demonstrated the safety and efficacy of transdermal nitric oxide (NO) donors, that serve to lower BP by vasodilation. However, beta ...Download file to see next pagesRead More
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