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Stroke & neuro
Prehospital SBP ≥180 linked with worse stroke outcomes
Effects of prehospital blood pressure on 90-day functional outcomes in patients with acute ischemic stroke due to large vessel occlusion
Journal of Stroke and Cerebrovascular Diseases · 2026-10-27 · Added 29 October 2026
A Japanese cohort of 1,106 EMS-transported acute large-vessel-occlusion stroke patients found prehospital SBP ≥180 mmHg associated with lower odds of good 90-day functional outcome (aOR 0.43) compared with SBP <120, with the association significant only in patients treated with endovascular thrombectomy.
- Study type
- Cohort
- Design
- Retrospective multicentre cohort
- Participants
- 1,106 EMS-transported LVO stroke patients, mean age 79, 60% thrombectomised
- Main finding
- SBP ≥180 vs <120 mmHg: adjusted OR 0.43 (95% CI 0.22–0.84) for mRS 0–2 at 90 days; significant in EVT-treated patients, not in non-EVT patients (interaction p=0.007); haemorrhagic complications similar across groups.
- Caveat
- Retrospective Japanese cohort; no prehospital antihypertensive treatment was tested, so management implications are unproven.
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Scene blood pressure measurement is universal Australian practice, but the actionable signal sits with stroke-pathway teams; thrombectomy is hospital care and association is not causation.
Learning goal
Weigh the risks and benefits of prehospital blood pressure management during suspected large vessel occlusion stroke transport.
More
- Topic: Stroke & neuro
- Daily scan: 29 October 2026
- Podcast: Paramedic Papers Daily, 29 October 2026
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