William Whiteley, PhD, MRCP, from the University of Edinburgh, discusses the details of two trials assessing blood pressure management in stroke presented at ESOC 2023. The first trial, INTERACT3 (NCT03209258), focused on patients with hemorrhagic stroke, investigating the efficacy of a multifaceted care bundle that included early, intensive blood pressure control. The study showed significantly improved outcomes for patients who received the comprehensive treatment package, compared to standard of care. However, Dr. Whiteley emphasized that this improvement is likely due to the overall enhanced care provided to these patients, rather than solely a blood pressure effect. In another trial from South Korea, OPTIMAL-BP (NCT04205305), patients who underwent thrombectomy for acute ischemic stroke were randomly assigned to lower or higher blood pressure control. Surprisingly, the group with lower blood pressure had worse stroke recovery. Based on this trial, Dr. Whiteley suggests that excessive concern about hypertension in the early stages after an ischemic stroke may not be warranted. Further research is necessary to refine guidelines and better understand the role of blood pressure control in stroke management.
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