Brain infarction developed in hypertensive and normotensive patients during hospitalization--hemodynamic factors.
To determine the effects of changes in blood pressure (BP) on the development of ischemic stroke, 17 patients who developed acute brain infarction during hospitalization were analyzed in relation to the vascular risk factors such as hypertension, previous stroke, diabetes mellitus, and hyperlipidemia. Their BPs were retrospectively referred to the onset of stroke. The average values of mean arterial blood pressure (MABP) on admission were 137 mmHg in hypertensive patients (HT; n = 9) and 101 mmHg in normotensives (NT; n = 8). HT patients received antihypertensive treatment after admission and MABP decreased by 22 mmHg (14%) prior to the ictus (three to sixty-five days after admission). MABP in NT patients remained constant before the attack (-1.4 mmHg, four to one hundred ten days after admission). Similarly, MABP decreased by 17 mmHg (four to ninety-three days) before the ictus in patients with previous stroke (n = 9), whereas it changed only a little in patients without history of stroke (n = 8). BP in each group elevated immediately after the stroke and gradually decreased to 90% of the resting level after two weeks. An excessive reduction of BP may induce brain infarction in HT or chronic stroke patients or cause it to recur.
Sugimori
H
H
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Ibayashi
S
S
Fujii
K
K
Yao
H
H
Sadoshima
S
S
Fujishima
M
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000503:physiopathology; D002544:Cerebral Infarction / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors