Blood pressure after stroke. A one-year follow-up study.
OBJECTIVE
Blood pressure changes in the year after acute stroke have been poorly documented.


METHODS
We therefore studied blood pressure for 1 year after discharge from the hospital in 226 consecutive patients (mean age, 73 years) surviving an acute stroke.


RESULTS
Marked increases (p < 0.001) in mean systolic and mean diastolic blood pressures were seen in two thirds (69%) of the patients 1 month after discharge, and blood pressure remained stable at this level during the remainder of the follow-up year. Similar blood pressure changes were seen irrespective of sex, final stroke diagnosis, or whether the patient had a history of hypertension before the stroke. Patients with a history of hypertension had significantly higher blood pressures (p < 0.001) throughout the follow-up year than previously normotensive patients. One month after discharge blood pressure was found to have decreased in 31% of the patients; these were older and had a higher mortality during the follow-up year than patients with blood pressure increases. About 20% of all patients suffered from orthostatism (defined as a decrease in systolic blood pressure of > or = 20 mm Hg when rising from the supine position to standing).


CONCLUSIONS
We conclude that antihypertensive treatment should not be reduced before discharge from the hospital and that blood pressure should be checked about 1 month after discharge. We suggest that standing blood pressure also be measured to make an appropriate treatment decision.
Carlsson
A
A
Karolinska Institute, Department of Medicine, Stockholm, Sweden.
Britton
M
M
D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000401:mortality / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D002546:Ischemic Attack, Transient / Q000503:physiopathology; D008297:Male; D013599:Systole / Q000502:physiology; D013997:Time Factors