title: Pulse pressure in acute stroke is an independent predictor of long-term mortality.
abstract: The management of blood pressure (BP) during the acute phase of stroke remains a matter of debate. The aim of the present study was to evaluate a possible association between long-term mortality and BP values in acute stroke by means of BP monitoring. We studied a consecutive series of 198 first-ever acute stroke patients. BP monitoring was initiated in all subjects within 24 h of ictus. One year after stroke onset, 34 (17.7%) patients had died. Multivariate Cox regression analysis revealed only age, level of consciousness on admission, lacunar stroke and 24-hour pulse pressure (24-hour PP) as significant outcome predictors. The hazards ratio for 1-year mortality associated with every 10 mm Hg increase in 24 h PP was 1.39 (95% CI: 1.04-1.86, p = 0.028). The present results demonstrate that increasing 24-hour PP levels in patients with acute stroke are independently associated with higher long-term mortality. This may have implications in acute stroke BP management and warrants further investigation.
authors.affiliation: Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece. vemmosk@ath.forthnet.gr
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Vemmos
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsivgoulis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spengos
authors.forename: Efstathios
authors.initials: E
authors.lastname: Manios
authors.forename: Michael
authors.initials: M
authors.lastname: Daffertshofer
authors.forename: Vassilios
authors.initials: V
authors.lastname: Kotsis
authors.forename: John P
authors.initials: JP
authors.lastname: Lekakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Zakopoulos
mesh_terms: D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality* / Q000503:physiopathology*; D016019:Survival Analysis