A topic in Clinical Evidence 1 summarizes the evidence on blood pressure reduction in acute ischaemic stroke. Blood pressure reduction soon after acute ischaemic stroke has not been adequately tested in large scale RCTs. One systematic review (search date 1997, 3 RCTs, 113 people) contained insufficient data to allow an analysis of the relation between changes in blood pressure (reduced by medication) and clinical outcome. In one RCT on nimodipine (n=295) was stopped early because of an excess of unfavourable neurological outcomes, which were related to reductions in mean arterial blood pressure and diastolic blood pressure. Another RCT (n=302) there was a non-significant increase in death for people taking beta blockers (atenolol or propranolol).
Comment: The quality of evidence is downgraded by sparse data and study limitations.
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