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Antihypertensives are administered selectively in emergency department patients with subarachnoid hemorrhage.

Publication ,  Journal Article
Culyer, V; McDonough, E; Lindsell, CJ; Alwell, K; Moomaw, CJ; Kissela, BM; Flaherty, ML; Khatri, P; Woo, D; Ferioli, S; Broderick, JP ...
Published in: J Stroke Cerebrovasc Dis
November 2013

Elevated blood pressure is common in patients with acute subarachnoid hemorrhage (SAH). American Heart Association guidelines do not specify a blood pressure target, but limited data suggest that systolic blood pressure (SBP)≥160 mmHg is associated with increased risk of rebleeding and neurologic decline. In a population-based study, we determined the frequency of antihypertensive therapy in emergency department (ED) patients with SAH and the proportion of those patients with SBP≥160 mmHg who received this therapy. In 2005, nontraumatic SAH cases were retrospectively ascertained at 16 hospitals in our region by screening for International Classification of Diseases Ninth Revision diagnostic codes 430-436. Blood pressure was recorded at ED presentation and also before and after any treatment with antihypertensives. Hypotension was defined as SBP<100 mmHg. The Mann-Whitney U test and χ2 test were used for comparisons. Our cohort comprised 82 patients with SAH presenting to an ED; 4 patients were excluded. The median age of the included patients was 54 years, 74.4% were female, 29.5% were black, and 31 (39.7%) had SBP≥160 mmHg. Antihypertensive therapy was given to 22 of 31 patients (70.9%) with SBP≥160 mmHg and to 4 of 47 patients (8.5%) with SBP<160 mmHg. No patients became hypotensive after receiving treatment. Age, sex, Glascow Coma Scale score, and National Institutes of Health Stroke Scale score were similar between treated and untreated patients. In the absence of definitive evidence, current blood pressure management in local EDs appears reasonable. Further studies of blood pressure management in acute SAH are warranted.

Duke Scholars

Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

November 2013

Volume

22

Issue

8

Start / End Page

1225 / 1228

Location

United States

Related Subject Headings

  • Young Adult
  • Subarachnoid Hemorrhage
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Glasgow Coma Scale
  • Female
  • Emergency Service, Hospital
 

Citation

APA
Chicago
ICMJE
MLA
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Culyer, V., McDonough, E., Lindsell, C. J., Alwell, K., Moomaw, C. J., Kissela, B. M., … Adeoye, O. (2013). Antihypertensives are administered selectively in emergency department patients with subarachnoid hemorrhage. J Stroke Cerebrovasc Dis, 22(8), 1225–1228. https://doi.org/10.1016/j.jstrokecerebrovasdis.2012.02.015
Culyer, Virginia, Erin McDonough, Christopher J. Lindsell, Kathleen Alwell, Charles J. Moomaw, Brett M. Kissela, Matthew L. Flaherty, et al. “Antihypertensives are administered selectively in emergency department patients with subarachnoid hemorrhage.J Stroke Cerebrovasc Dis 22, no. 8 (November 2013): 1225–28. https://doi.org/10.1016/j.jstrokecerebrovasdis.2012.02.015.
Culyer V, McDonough E, Lindsell CJ, Alwell K, Moomaw CJ, Kissela BM, et al. Antihypertensives are administered selectively in emergency department patients with subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2013 Nov;22(8):1225–8.
Culyer, Virginia, et al. “Antihypertensives are administered selectively in emergency department patients with subarachnoid hemorrhage.J Stroke Cerebrovasc Dis, vol. 22, no. 8, Nov. 2013, pp. 1225–28. Pubmed, doi:10.1016/j.jstrokecerebrovasdis.2012.02.015.
Culyer V, McDonough E, Lindsell CJ, Alwell K, Moomaw CJ, Kissela BM, Flaherty ML, Khatri P, Woo D, Ferioli S, Broderick JP, Kleindorfer D, Adeoye O. Antihypertensives are administered selectively in emergency department patients with subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2013 Nov;22(8):1225–1228.
Journal cover image

Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

November 2013

Volume

22

Issue

8

Start / End Page

1225 / 1228

Location

United States

Related Subject Headings

  • Young Adult
  • Subarachnoid Hemorrhage
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Glasgow Coma Scale
  • Female
  • Emergency Service, Hospital