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Permissive hypotension or hypotensive resuscitation [1] is the use of restrictive fluid therapy, specifically in the trauma patient, that increases systemic blood pressure without reaching normotension (normal blood pressures). The goal blood pressure for these patients is a mean arterial pressure of 40-50 mmHg or systolic blood pressure of ...
Cerebral infarction, also known as an ischemic stroke, is the pathologic process that results in an area of necrotic tissue in the brain (cerebral infarct). [1] In mid to high income countries, a stroke is the main reason for disability among people and the 2nd cause of death. [2]
The aim is to achieve a systolic blood pressure of 90 mmHg in order to maintain tissue perfusion without inducing re-bleeding from recently clotted vessels. Permissive hypotension is a means of restricting fluid administration until hemorrhage is controlled while accepting a short period of suboptimal end-organ perfusion.
The most common presentation of cerebrovascular disease is an ischemic stroke or mini-stroke and sometimes a hemorrhagic stroke. [2] Hypertension (high blood pressure) is the most important contributing risk factor for stroke and cerebrovascular diseases as it can change the structure of blood vessels and result in atherosclerosis. [5]
The risk of HT increases with the severity and duration of the initial stroke, as well as with certain medical conditions such as high blood pressure, diabetes, and clotting disorders [3] and the use of certain medications, such as anticoagulants and thrombolytic tpA medication (such as alteplase) which can increase the bleeding risk. [4] [5]
Hypertension is the leading cause of strokes and studies show that it increases the risk of a stroke by 220% [17] [18] and stroke is the leading cause of long-term disability. [19] High blood pressure weakens arteries (small vessel disease) and causes blood vessels to be more likely to clog and/or burst.
Hypertension (high blood pressure) Diabetes mellitus; Menopause; Excessive alcohol consumption; Severe migraine; Hypertension is the strongest risk factor associated with intracerebral hemorrhage and long term control of elevated blood pressure has been shown to reduce the incidence of hemorrhage. [7]
Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke, heart failure, kidney failure and myocardial infarction. Evidence suggests that a reduction of blood pressure by 5 mmHg can decrease the risk of stroke by 34% and of ischaemic heart disease by 21%.