Blood pressure and cerebral ischemia A continuing dilemma

摘要

Classical neurologic teaching suggests that a higher cerebral systemic blood pressure (BP) be targeted for individuals with occlusive carotid disease, in order to improve cerebral perfusion through collaterals. This conflicts, however, with observational, population-based studies and clinical trials supporting better outcomes associated with lower BPs. In this issue of Neurology (R), Powers et al.(1) evaluate nonsurgical controls from the Carotid Occlusion Surgery Study (COSS), and report lower rates of stroke recurrence in individuals maintained at a follow-up BP of 130/85 mm Hg or lower.