Personalized blood pressure management may aid stroke recovery

By Bill Hathaway

Post-stroke management — particularly the regulation of blood pressure — is crucial to achieve the best outcome for patients. However, normal regulation of blood flow to the brain can be disrupted by stroke. If a patient’s blood pressure is too low, brain tissue can suffer further damage and tissue loss. In contrast, elevated blood pressure can increase the risk of hemorrhagic transformation, a type of bleed into the injured brain tissue that may occur after stroke.

Now, a team of Yale researchers within the Division of Neurocritical Care and Emergency Neurology has devised a way to assess optimal blood pressure levels for individual patients with the hope of preventing further brain injury and improving outcomes. Lead authors Nils Petersenand fourth-year medical student Andrew Silverman used near-infrared spectroscopy to identify and track optimal blood pressure levels in patients with ischemic stroke after undergoing endovascular therapy to remove the blood clot causing the stroke. The study authors were able to identify personalized blood pressure thresholds based on individual patient physiology, and they hypothesize that deviation from these ideal thresholds correlates with hemorrhagic transformation and worse functional outcomes. The researchers hope a future clinical trial will show that using this tool to adjust blood pressure readings for individual patients will reduce damage caused by unregulated blood flow after stroke.

Diagram comparing brain scans with and without evidence of hemorrhagic transformation.
Top: Exceeding personalized blood pressure limits may lead to post-stroke complications like hemorrhagic transformation and thus worse outcomes. Bottom: If patients’ blood pressures oscillate within these personalized thresholds, they may follow a better clinical course.

Kevin Sheth, associate professor of neurology and neurosurgery, is senior author of the paper published July 29 in the journal JAMA Neurology on July 29.


Yale University


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