The American Stroke Association released a new study that examined the link between high blood pressure and stroke and how fluctuating blood pressure after a stroke may indicate increased risk of death. The study evaluated data from 1,947 patients who had four to five blood pressure readings within 24 hours of a stroke.  The study found that those patients with a greater variation in their systolic blood pressure (the top number in the measurement), were at higher risk of death within 90 days of a stroke.

Dr. Adam de Havenon the lead author of the study said the results showed the significance of fluctuating blood pressure and its importance as a risk factor for poor outcomes after a stroke. “It’s a fertile topic that’s gaining attention, and I would argue that we need to pay even more attention to it,” said Dr. de Havenon, an assistant professor of neurology at the University of Utah School of Medicine.


What treatment options may help reduce the risk of death after a stroke?

He recommended that those patients with a variation in their systolic blood pressure may be treated with calcium channel blockers – instead of beta-blockers, to more effectively decrease variability.  “In my own practice, I have started to think about ways to reduce variability using different medications,” he said.  “It’s something that might be easily addressed with small modifications.” He asks some patients to tract their blood pressure variability throughout the day.  “That way you get a sense of which patients have a rock-solid blood pressure that’s well-controlled by medication, and which patients have blood pressure that is jumping around during the course of the day,” de Havenon said.


More clinical trials are needed to identify patients with variability and the best treatment protocols.

Dr. Paul Muntner, a professor of epidemiology at the University of Alabama School of Public Health said the new study “could allow us to direct treatment more intently to a population that’s at higher risk.”  He said more clinical trials are needed on the topic since questions remain.  “It’s premature to say that people should be prescribed certain medications specifically for blood pressure variability—the jury is still out for that,” Dr. Muntner said.

“The other interesting question is, is it blood pressure variability itself that increases the risk, or is it some other underlying condition, like high levels of inflammation or stiff arteries, which could also cause large fluctuations in blood pressure?” he asked.

“As we utilize technology more and more, we’ll be able to get a better long-term picture of a person’s risk based on their blood pressure over a period of 24 hours or several months, and that’s going to really help us personalize risk and treatment,” Dr. Muntner said.

MedTrust Transport provides emergent and non-emergent ambulance services in Charleston, Myrtle Beach, Georgetown, South Carolina and Jacksonville, Florida.  We have trained EMT personnel and a fleet of fully-equipped ambulances.  We aim to provide passionate and timely patient care.