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(Hypertension. 2004;43:137.)
© 2004 American Heart Association, Inc.

Hypertension Grand Rounds

Blood Pressure Management in Patients With Acute Ischemic Stroke

Larry B. Goldstein

From Department of Medicine (Neurology), Duke Center for Cerebrovascular Disease, and the Stroke Policy Program, Center for Clinical Health Policy Research, Duke University, Durham, NC and Veterans Administration Medical Center, Durham, NC.

Correspondence to Dr Larry B. Goldstein, Director, Duke Center for Cerebrovascular Disease, Head, Stroke Policy Program, Center for Clinical Health Policy Research, Box 3651-DUMC, Durham, NC 27710. E-mail golds004@mc.duke.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Case
A 68-year-old right-hand-dominant man was brought to the hospital because of a speech disturbance and right arm and leg weakness. He awoke with these deficits and was last known to be symptom-free when retiring to bed the previous evening 8 hours earlier. His past medical history was notable for coronary heart disease, the patient having underwent coronary artery bypass surgery 7 years previously for unstable angina, but he had no known history of myocardial infarction. He also had hypertension and hyperlipidemia, and smoked 1 pack of cigarettes daily for more than 40 years. He had no history of calf claudication. His hypertension was being treated with a diuretic and ß-adrenergic receptor blocker. He was also prescribed 325 mg of aspirin daily and an HMG CoA-reductase inhibitor (statin); however, his wife remarked that he often forgot to take his medications. His last total cholesterol was 240 mg/dL, with LDL cholesterol of 130 mg/dL. He had a strong family history of coronary heart disease after the age of 50. He had no known drug allergies.

Physical Examination
The patient’s blood pressure was 195/100 mm Hg in both arms, with a regular pulse of 90 bpm. His weight was 225 lb (body mass index: 31.4 kg/m²). His lungs were clear to auscultation. Cardiac examination showed a laterally displaced point of maximum impulse with an S₄ gallop and a soft nonradiating systolic murmur at the base. His abdomen was obese without organomegaly and no abdominal bruits were detected. He had no rashes and no joint . . . [Full Text of this Article]

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