What is the maximum blood pressure at which tPA is contraindicated?

The correct maximum blood pressure at which tissue plasminogen activator (tPA) is contraindicated in the setting of an acute ischemic stroke is 185/110 mmHg. This threshold is crucial because elevated blood pressure can increase the risk of hemorrhagic transformation, which is a serious complication that can occur with the use of thrombolytic agents like tPA.

Patients with blood pressure readings above 185/110 mmHg may be at higher risk for bleeding when tPA is administered. Therefore, it is standard practice to manage and lower blood pressure to below this level before considering tPA therapy in individuals presenting with acute ischemic stroke.

This guideline is particularly important given that the administration of tPA is associated with a higher risk of intracranial hemorrhage. Maintaining blood pressure within safe limits helps to minimize this risk during treatment. Thus, 185/110 mmHg serves as a critical threshold to ensure patient safety and optimize the therapeutic potential of tPA.