What is the threshold diastolic blood pressure for withholding fibrinolytic therapy in acute ischemic stroke?

In the context of acute ischemic stroke, fibrinolytic therapy, such as the administration of tissue plasminogen activator (tPA), is a critical intervention that must be weighed against the risks associated with the patient's overall condition. The threshold diastolic blood pressure for withholding fibrinolytic therapy is identified at 110 mmHg.

This threshold is established based on the understanding that elevated blood pressure can increase the risk of hemorrhagic complications, particularly intracranial hemorrhage, which is a serious concern when administering fibrinolytics. Maintaining diastolic blood pressure below this threshold is crucial for ensuring patient safety and minimizing the risk of complications. Thus, if a patient’s diastolic blood pressure is equal to or exceeds 110 mmHg, fibrinolytic therapy may be withheld until the blood pressure can be managed appropriately.

Understanding this guideline helps clinicians to make informed decisions regarding thrombolytic therapy in the acute setting, emphasizing the balance between the benefits of rapid reperfusion and the risks posed by hypertension.