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While this study is imperfect and may not be measuring patient important outcomes, it does fit with other literature on the topic of intensive blood pressure control in patients with acute ischemic stroke. These patients were randomized to aggressive blood pressure control (SBP 130-140 within 1 hour of TPA administration continued for 72 hours) or the standard SBP <180. Repeat imaging was performed to assess the degree of cerebral swelling that each group developed. There was no difference in swelling between the two groups.
Take away is aggressive blood pressure management in this group of ischemic stroke patients does not seem to be beneficial.
References
Zhang G, Chen C, Ren X, Zhao Y, Ouyang M, Billot L, Li Q, Wang X, Zhang L, Ong S, Liu L, You S, Lindley RI, Robinson TG, Li G, Chen X, Sui Y, Anderson CS, Song L; ENCHANTED Investigators. Effects of Intensive Blood Pressure Lowering on Brain Swelling in Thrombolyzed Acute Ischemic Stroke: The ENCHANTED Results. Stroke. 2025 Jun;56(6):1388-1395. doi: 10.1161/STROKEAHA.124.049938. Epub 2025 Apr 3. PMID: 40177745.