A Systematic Review On The Efficacy And Safety Of Early Blood Pressure Lowering In Stroke

Background: Although the benefit of controlling hypertension for primaryand secondary prevention has been established, the effect of early blood pressurereducing in stroke is unclear.Objectives: To evaluate early blood pressure reducing in stroke whetherimprove outcome or not.Search methods: We electronically searched the Medline、 Embase、Cochrane Library、CNKI、VIP、Wanfang database and manually searched somerelated field of Chinese Journals.Methods: Randomized controlled trials (RCTs) comparing whether earlyblood pressure reduction in patients with stroke are included. The outcome aredeath and major disability and adverse event.Results: A total of eight RCTs were included, which antihypertensive groupcontained5191participants and control group contained5166participants.Meta-analysis showed that the death and major disability at14days had nostatistical significance [P=0.75， RR=1.01,95%CI：（0.94,1.09）] between antihypertensive group and control group. Results of the death and majordisability at3m had no statistical significance[P=0.23，RR=0.97，95%CI：（0.91,1.02）]. Subgroup analyses of the death and major disability of at3mwere conducted according to age＜65y, age≥65y, with history of hypertension,without hypertension history, blood＜180mmHg, blood≥180mmHg, andresults showed no statistical significance. There was no statistical significance inthe result of the death and major disability at6m[P=0.47，RR=1.04，95%CI：（0.94,1.15）]. No statistically significance was observed between two groupsin adverse event [P=0.90，RR=1.01，95%CI：（0.89,1.14）].Conclusions: There is no enough evidence to demonstrate that early bloodpressure reducing in stroke improve or aggravate outcome.