title: Relationship between outcome and baseline blood pressure and other haemodynamic measures in acute ischaemic stroke: data from the TAIST trial.
abstract: BACKGROUND
  A poor outcome after stroke is associated independently with high blood pressure during the acute phase; however, relationships with other haemodynamic measures [heart rate (HR), pulse pressure (PP), rate-pressure product (RPP)] remain less clear.
  
  
  METHODS
  The Tinzaparin in Acute Ischaemic Stroke Trial is a randomised, controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1484 patients with acute ischaemic stroke. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR measurements taken immediately prior to randomization were averaged, and the mid-blood pressure (MBP), PP, mean arterial pressure (MAP), pulse pressure index, and RPP were calculated. The relationship between these haemodynamic measures and functional outcome (death or dependency, modified Rankin Scale > 2) and early recurrent stroke, were studied with adjustment for baseline prognostic factors and treatment group. Odds ratios (OR) and 95% confidence intervals (CI) refer to a change in haemodynamic measure by 10 points.
  
  
  RESULTS
  A poor functional outcome was associated with SBP (adjusted OR; 1.11; 95% CI, 1.03-1.21), HR (adjusted OR; 1.15; 95% CI, 1.00-1.31), MBP (adjusted OR; 1.15, 95% CI, 1.03-1.29), PP (adjusted OR; 1.14; 95% CI, 1.02-1.26), MAP (adjusted OR; 1.15; 95% CI, 1.02-1.31) and RPP (adjusted OR; 1.01; 95% CI, 1.00-1.02). Early recurrent stroke was associated with SBP, DBP, MBP and MAP.
  
  
  CONCLUSIONS
  A poor outcome is independently associated with elevations in blood pressure, HR and their derived haemodynamic variables, including PP and the RPP. Agents that modify these measures may improve functional outcome after stroke.
authors.affiliation: Institute of Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Nikola
authors.initials: N
authors.lastname: Sprigg
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.forename: Philip M W
authors.initials: PM
authors.lastname: Bath
authors.forename: Gudrun
authors.initials: G
authors.lastname: Boysen
authors.forename: Peter Paul
authors.initials: PP
authors.lastname: De Deyn
authors.forename: Pal
authors.initials: P
authors.lastname: Friis
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
authors.forename: Reijo
authors.initials: R
authors.lastname: Marttila
authors.forename: Jan-Edwin
authors.initials: JE
authors.lastname: Olsson
authors.forename: Desmond
authors.initials: D
authors.lastname: O'Neill
authors.forename: Bernd
authors.initials: B
authors.lastname: Ringelstein
authors.forename: Jan-Jacob
authors.initials: JJ
authors.lastname: van der Sande
authors.forename: Ewa
authors.initials: E
authors.lastname: Lindenstrøm
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006339:Heart Rate / Q000502:physiology*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D055502:Secondary Prevention; D020521:Stroke / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D000078222:Tinzaparin
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin