Early blood pressure control in ambulances shows no clear benefit for stroke patients, study finds

By Dr. Priyom Bose, Ph.D.May 20 2024Reviewed by Benedette Cuffari, M.Sc. A recent New England Journal of Medicine study assesses whether early blood-pressure control within ambulances leads to favorable clinical outcomes among patients with undifferentiated acute stroke.

Previously, two trials reported similar results on the efficacy and safety of administering pre-hospital blood pressure reduction interventions within hours of an acute stroke. In patients with intracerebral hemorrhage, worse outcomes were noted in those who received the glyceryl trinitrate patch relative to those who received a sham patch.

The primary safety outcome was the occurrence of any serious adverse event. The primary efficacy outcome was assessed by reading the score on the modified Rankin scale, in which a score of zero represented no symptoms and a score of six represented death. The scores were noted 90 days after randomization.

When the patients arrived at the hospital, the average systolic blood pressure measurements in the intervention and usual care groups were 158 and 170 mm Hg, respectively. No difference in functional outcomes was observed across the intervention and usual care groups. Furthermore, the incidence of serious adverse events was similar across the two studied groups.

One limitation included the involvement of doctors in emergency services, which reduces the generalizability of the findings. Additionally, the current study was conducted in China, where the nature of stroke is different from that in North America and Europe.

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