Is reducing blood pressure in patients after treatment for ischemic stroke a safe way to achieve better results?
This is a question asked by researchers led by Eva Mistry University of Cincinnati looking for an answer by blood test after Endovascular Stroke Therapy-II (BEST-II) clinical trial.
Mistry, MD, explained the first idea that led to this study began when she was a second-year resident at a Houston Methodist hospital in 2015, when a new severe stroke treatment called endovascular thrombectomy, a simple method that uses a catheter. to remove a blood blood vessels from the blood vessels in the brain to patients suffering from stroke, are studied and presented.
After receiving a thrombectomy, patients will be referred to intensive care units, and Mistry will be on call for night care.
One of the main concerns of patients is their care and management high blood pressure, Mistry said. High blood pressure after a stroke is associated with an increased risk of bleeding, but there is also concern that reducing high blood pressure will not provide enough blood flow to the brain area where the stroke occurred.
“Obviously we don’t have any information to guide us,” said Mistry, an assistant professor in the Department of Physiology and Medicine at UC College of Medicine and UC Medical School. “That is when the question came to my mind about what is the relationship between high blood pressure in the ICU and the consequences for stroke patients undergoing thrombectomy.”
In 2017, Mistry and her colleagues conducted a observational study that was the first to demonstrate a relationship between. high blood pressure the negative outcome of the patient after thrombectomy.
When Mistry came to UC for pulse coagulation, she helped lead an in-depth study that sought to identify the exact cause of high blood pressure associated with better or worse outcomes following thrombectomy procedures. This study is based on systolic hypertension of 160 millimeters of mercury remains the distribution line, with lower blood pressure associated with better outcomes and high blood pressure associated with worse outcomes.
The BEST-II study is an expanded test to find out if lowering blood pressure is safe for patients. In the experiment, 120 patients who used thrombectomy techniques to treat severe stroke were placed in one of three treatment groups.
Using high blood pressure medications, one group had a systolic blood pressure target of less than 140 mm. or equal to 180 mm.
“The BEST-II is the second test in this particular field, so it’s an interesting question, but it’s also a test model again,” Mistry said.
Mistry filters if the blood is low pressure found to be unsafe, it would be important to share this information immediately since there are various current goals set by stroke doctors across the country.
“On the other hand, if they are healthy, then we would recommend conducting a thorough study to see if they are effective in improving long-term performance outcomes. stroke patientssaid Mistry.
BEST-II is the first time that Mistry has acted as a major ground researcher (PI) for randomized clinical trials. Under her leadership, she completed her registration in February, before completing her program. Mistry says its work as a national PI on the previous BEST-I observational analysis helped her get ready to take the lead of several websites randomized trial.
“It is good to be able to interpret this in the most rigorous and experimental clinical trials that have its own and more specific procedures and specific contracts,” she said. “Our entire UC stroke team, researchers as well as patients and families have all been exceptional in their commitment to advancing this future and contributing to the best possible outcome for future patients as much as possible.”
Pooja Khatri, MD, associate professor of Mistry and professor of neurology at UC College of Medicine, says Mistry is committed to continuing to manage stroke for its patients and is always trying to think and create collaborations. to help the sick. Completing the registration as soon as the disease is reduced or stopping the test and with a limited budget shows Mistry’s “New and Efficient System” for clinical testing at the beginning of its operation, Khatri said.
“It simply came to our notice then leadership skills and her ability to create the perfect test of ability, ”Khatri said. generosity.”
In addition to leading BEST-II, Mistry was recently an invited participant at the National Institute of Medicine (NAM) Conference of Developing Leaders in Washington, DC Invited attendees must be selected by a member of NAM to attend great event, and Mistry chose her. Roger Lewis, MD, leads at UCLA.
The Leadership Development Program provides an opportunity for young professionals in all fields of health and medicine to collaborate to find new ways to tackle the most difficult problems in the field and bring about immediate change.
“He was very open-minded to meet people working in fields that I never thought would have much impact on human life,” Mistry said. “I have met social scientists, economists, lawyers, anthropologists, people from all walks of life and professions with the same goal of improving human health.”
The event also brought together young professionals along with NAM members, counselors and other professional experts. Mistry says she enjoys meeting and hearing from mentors who are strangers and have a similar professional approach to her own.
“As a stranger, when I was pregnant medical school for example, I have no knowledge of research and in fact I do not know how to read a clinical test paper and its interpretation, ”she said. it’s very important to me. ”
Mistry said attending the conference expanded her thinking to see how her research fits the big picture of working to improve human health.
“What I’m doing is a small piece of the main goal,” she said. “So it made my work more important and smaller at the same time, which really opened my eyes.”
Another key theme that Mistry has taken from the platform is the issue of research consistency, which includes working to ensure that the number of patients participating in clinical research is representative of the general public.
“None of the PI says, ‘I want to discriminate against people of a particular ethnic group,’ for example, but we only organize studies in such a way that perhaps the inclusion / exclusion criteria do not discriminate against minorities and marginalized people,” he said. per. “We have many examples to show that the number of people we enroll in in our studies is not proportional to the incidence of the diseases we see in high-risk communities.”
Mistry said it recently launched a support application to seek to bring more consistency into in-depth research ahead of the event, so it remains clear that this is an important research to follow.
The workshop also included discussions on the implementation of research in practice, so that if researchers conduct research the knowledge will be shared with the community and used to improve patient care.
“If pulse research, we have seen many treatments take years and years to be implemented at the community level, either because doctors are skeptical or patients are skeptical, “she said., it is a waste of time and resources. It opened my eyes. to know that the timing of clinical research is critical. ”
University of Cincinnati
hintHow High Blood Pressure Affects Stroke Recovery (2022, July 1) Retrieved July 1, 2022 from https://medicalxpress.com/news/2022-07-blood-pressure-affects-recovery.html
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