Blood pressure management in reperfused ischemic stroke.
Varela LB et al., 2026 · 9 studies included
Summary
Nine trials, 4,381 participants after ischemic-stroke reperfusion; seven EVT trials and two thrombolysis trials with varied intensive targets.
Conclusion
Intensive BP control probably increased mortality (RR 1.19, 95% CI 1.08–1.32; moderate certainty) and did not reduce any ICH (RR 0.99, 0.87–1.14; high certainty). This supports avoiding routine intensive post-reperfusion lowering. Follow AHA/ASA 2026 recommendations, preserve perfusion and account for separate urgent indications rather than pooling all tested targets into one universal threshold.