OPTIMAL-BP trial compared intense vs. conventional blood pressure lowering after stroke thrombectomy.
The study asked whether aggressively lowering blood pressure shortly after successfully opening blocked blood vessels in acute stroke patients is beneficial. They found that 39.4% of patients with aggressive blood pressure management (aiming for lower levels) achieved functional independence after three months, compared to 54.4% of those with conventional management (aiming for slightly higher levels). This indicates that aggressively lowering blood pressure in the first 24 hours after reperfusion may not be helpful and could even be harmful for stroke patients who had endovascular thrombectomy.
Nam HS: The OPTIMAL-BP Randomized Clinical Trial. JAMA. 2023;330(9):832–842. doi:10.1001/jama.2023.14590Kim YD Heo J, et al. Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke