Blood pressure changes during the initial week after different subtypes of ischemic stroke.
OBJECTIVE
The purpose of this study was to clarify the differences in the acute blood pressure course among different ischemic stroke subtypes.


METHODS
We divided 588 consecutive patients with acute brain infarction into four clinical subgroups to study the blood pressure levels during the initial 6 hospital days.


RESULTS
During the 6 days, systolic blood pressure of lacunar and atherothrombotic patients was higher (P=0.0001) and diastolic blood pressure of lacunar patients was higher (P=0.0371) than of patients with the other subtypes. Preexisting hypertension was associated with elevated acute systolic blood pressure in all patients and in each subtype and with elevated acute diastolic blood pressure in all patients, cardioembolic patients, and patients with stroke of other etiology. After adjustment by preexisting hypertension, diabetes mellitus with a hemoglobin A1c >7.0% was associated with elevated systolic blood pressure in all, lacunar, and cardioembolic patients and with diastolic blood pressure in all patients.


CONCLUSIONS
Blood pressure course of patients sustaining acute stroke varied widely according to stroke subtypes. Poorly controlled diabetes mellitus, as well as preexisting hypertension, appeared to influence blood pressure during the initial week of stroke.
Toyoda
Kazunori
K
Department of Cerebrovascular Disease and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. toyoda@hsp.ncvc.go.jp
Okada
Yasushi
Y
Fujimoto
Shigeru
S
Hagiwara
Noriko
N
Nakachi
Koh
K
Kitazono
Takanari
T
Ibayashi
Setsuro
S
Iida
Mitsuo
M
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D020520:Brain Infarction / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D002545:Brain Ischemia / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D048909:Diabetes Complications / Q000503:physiopathology; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000503:physiopathology; D020766:Intracranial Embolism / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D013997:Time Factors