Blood pressure in the initial phase of acute ischaemic stroke: evolution and its role as an independent prognosis factor at discharge and after 3 months of follow-up.
BACKGROUND
A prospective observational study was aimed at assessing the role of blood pressure (BP) during the first 24 h from stroke onset on the outcome of acute ischaemic stroke.


METHODS
Subjects admitted within the first 3 h from stroke onset were included. Stroke severity was evaluated with the Canadian Stroke Scale (CSS). Functional recovery was defined as a modified Rankin Scale score < or =2.


RESULTS
One hundred subjects were included. In a logistic regression model, the independent predictors of poor functional recovery at discharge were: age (OR = 1.12; 95% CI 1.04-1.21; p = 0.0033), non-lacunar stroke subtype (OR = 4.31; 95% CI 1.07-17.31; p = 0.0395), diabetes mellitus (OR = 8.38; 95% CI 1.67-41.95; p = 0.0097), a CSS score at admission < or =8 (OR = 28.64; 95% CI 5.59-146.68; p<0.0001), an average systolic BP during the first 6 h > or =180 mmHg (OR = 13.34; 95% CI 1.34-133.10; p = 0.0272) and a lower diastolic BP average from 6 to 24 h (OR for 5 mmHg increase: 0.57; CI 95% 0.36-0.88; p = 0.0115). Similar results were observed after 3 months of follow-up.


CONCLUSIONS
In ischaemic stroke patients, systolic BP over 180 mmHg in the first 6 h and a decrease of diastolic BP during the 6-24 h from stroke onset were independent predictors of a poor functional recovery.
Armario
Pedro
P
Department of Internal Medicine, Hypertension and Vascular Risk Unit, Hospital General de L'Hospitalet, Universitat of Barcelona, Barcelona, Spain. pedro.armario@sanitatintegral.org
Mártin-Baranera
Montserrat
M
Miguel Ceresuela
Luis
L
Hernández Del Rey
Raquel
R
Iribarnegaray
Eduardo
E
Pintado
Sara
S
Avila
Asunción
A
Bello
Juan
J
Luis Tovar
José
J
Alvarez-Sabin
José
J
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003971:Diastole; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology*; D013599:Systole