Acute cerebral infarction Patients Risk of Keeping Blood Pressure Low After Treatment for Arterial Vascular Reopening
Nov 20, 2025
Professor Nam Hyo-seok of the Department of Neurology at Severance Hospital led to the recently announced revision of the guidelines for acute cerebral infarction by the American Heart Association and the Korean Stroke Association.
Acute cerebral infarction is a disease in which blood clots block blood vessels in the brain, reducing blood and oxygen levels, causing brain damage. Brain damage causes fatal aftereffects such as hemiplegia and speech disorders, so blood vessels should be pierced as soon as possible.
If the amount of blood clots is large, blood vessel reopening treatment is performed to remove blood clots by inserting a tube into the artery. After successful reopening treatment, systolic (maximum) blood pressure management is important to prevent cerebral hemorrhage caused by excessive blood flow through the cerebrovascular.
Prior to the revision of the guidelines, medical guidelines in the United States and Europe recommended maintaining systolic blood pressure below 180 mmHg after arterial reopening treatment. However, most retrospective studies have stated that adjusting lower than 180 mmHg is good for patient prognosis, and even in actual treatment, it is often treated with low target blood pressure.
Professor Nam Hyo-seok's team published the results of a randomized clinical trial study in the Journal of American Medical Association (JAMA) that adjusting the blood pressure of patients with acute cerebral infarction who received arterial vascular reopening treatment in 2023 (less than 180mmHg) increases the risk of poor prognosis by 1.84 times.
Based on these results, the American Heart Association and the Korean Stroke Association emphasized patient safety by adding that it is dangerous to manage the blood pressure of acute cerebral infarction patients who have received arterial vascular reopening treatment below 140mmHg through the revision of the treatment guidelines in 2025. The added guideline was that the level of evidence received from the American Heart Association and the Korean Stroke Association was the highest at level A and level Ia, respectively.
Professor Nam Hyo-seok explained that performing arterial vascular reopening treatment and keeping blood pressure excessively low are dangerous, leading to revision of guidelines used in the practice field"After a successful reopening treatment, maintaining a systolic blood pressure of less than 140 mmHg is dangerous, so the target value should be seen as 140-180 mmHg."
Acute cerebral infarction is a disease in which blood clots block blood vessels in the brain, reducing blood and oxygen levels, causing brain damage. Brain damage causes fatal aftereffects such as hemiplegia and speech disorders, so blood vessels should be pierced as soon as possible.
If the amount of blood clots is large, blood vessel reopening treatment is performed to remove blood clots by inserting a tube into the artery. After successful reopening treatment, systolic (maximum) blood pressure management is important to prevent cerebral hemorrhage caused by excessive blood flow through the cerebrovascular.
Prior to the revision of the guidelines, medical guidelines in the United States and Europe recommended maintaining systolic blood pressure below 180 mmHg after arterial reopening treatment. However, most retrospective studies have stated that adjusting lower than 180 mmHg is good for patient prognosis, and even in actual treatment, it is often treated with low target blood pressure.
Professor Nam Hyo-seok's team published the results of a randomized clinical trial study in the Journal of American Medical Association (JAMA) that adjusting the blood pressure of patients with acute cerebral infarction who received arterial vascular reopening treatment in 2023 (less than 180mmHg) increases the risk of poor prognosis by 1.84 times.
Based on these results, the American Heart Association and the Korean Stroke Association emphasized patient safety by adding that it is dangerous to manage the blood pressure of acute cerebral infarction patients who have received arterial vascular reopening treatment below 140mmHg through the revision of the treatment guidelines in 2025. The added guideline was that the level of evidence received from the American Heart Association and the Korean Stroke Association was the highest at level A and level Ia, respectively.
Professor Nam Hyo-seok explained that performing arterial vascular reopening treatment and keeping blood pressure excessively low are dangerous, leading to revision of guidelines used in the practice field"After a successful reopening treatment, maintaining a systolic blood pressure of less than 140 mmHg is dangerous, so the target value should be seen as 140-180 mmHg."
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This article was translated by Naver AI translator.
