Title: Blood Pressure Management Updates from the 2013 Acute Ischemic Stroke Guideline
题目：2013年急性缺血性脑梗死指南对血压处理的更新
Author 作者: Bryan Hayes

The newest iteration of 'Guidelines for the Early Management of Patients with Acute Ischemic Stroke' was recently published. Here are the key revisions specific to blood pressure management:
最新理念的“急性缺血性脑梗死早期治疗的指南”刚刚发表。这里是几个有关血压控制的关键论点。
In patients with markedly elevated blood pressure who do not receive fibrinolysis, a reasonable goal is to lower blood pressure by 15% during the first 24 hours after onset of stroke. The level of blood pressure that would mandate such treatment is not known, but consensus exists that medications should be withheld unless the systolic blood pressure is >220 mmHg or the diastolic blood pressure is >120 mmHg.
对于血压明显增高但又不适合溶栓的病人， 标准是在发病24小时内将血压降低15％。但什么水平的血压需要这样的处理还不清楚。专家一致公认的是，只要收缩压不高于220mmHg或舒张压不高于120mmHg，就不要使用降压药。
No data are available to guide selection of medications for the lowering of blood pressure in the setting of acute ischemic stroke. Labetalol and/or nicardipine are listed as preferred, but other options can be used.
在急性缺血性脑梗死情况下如何选择降压药，还没有参考数据。拉贝洛尔和／或尼卡地平是首选的，但也可以有其它的选择。
Restarting antihypertensive medications is reasonable after the first 24 hours for patients who have preexisting hypertension and are neurologically stable.
在第一个24小时后，对发病前患有高血压并且神经方面稳定的病人可以考虑恢复抗高血压药。
If administering rtPA, blood pressure needs to be <185/110 mm Hg. That recommendation didn't change.
如用rtPA，血压需要控制在低于185／110mmHg。这方面的建议没有改变。

References 参考文献
Jauch EC, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013 Jan 31 [Epub ahead of print]. PMID 23370205.