title: [Systolic blood pressure and functional outcome in patients with acute stroke: a Mexican registry of acute cerebrovascular disease (RENAMEVASC)].
abstract: OBJECTIVE
  To analyze the association between the admission systolic blood pressure (SBP) and 30-day outcome in patients with acute cerebrovascular disease.
  
  
  METHODS
  The REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) is a hospital-based multicenter registry performed between November 2002 and October 2004. A total of 2000 patients with clinical syndromes of acute cerebrovascular disease confirmed by neuroimaging were registered. The modified Rankin scale was used for outcome stratification.
  
  
  RESULTS
  We analyzed 1721 patients who had registered their SBP: 78 (4.5%) had transient ischemic attack, 894 (51.9%) brain infarction, 534 (30.9%) intracerebral hemorrhage, 165 (9.6%) subarachnoid hemorrhage and 50 (2.9%) cerebral venous thrombosis. Among 1036 (60.2%) patients with the antecedent of hypertension, only 32.4% had regular treatment. The 30-day case fatality rate presented a J pattern with respect to SBP, so that the risk of death was highest in <100 mmHg (37.5%), decreased between 100 and 139, and reached gradually a new zenith in ?220 mmHg (35.3%). The best functional outcome corresponded to patients who had SBP between 100 mmHg and 159 mmHg. In a Cox proportional hazards model, SBP <100 mmHg or ?220 mmHg was an independent risk factor for 30-day mortality (RR: 1.52, IC 95%: 1.07 - 2.15), as well as the antecedent of hypertension (RR: 1.33, IC 95%: 1.06 - 1.65) and age >65 years (RR: 2.16, IC 95%: 1.74 - 2.67).
  
  
  CONCLUSIONS
  Both hypotension and significant arterial hypertension at hospital admission are associated with an adverse outcome after acute cerebrovascular disease. Nevertheless, a good functional outcome can be attained in a wide range of SBP.
authors.affiliation: Hospital General Ticomán, Servicio de Medicina Interna, D. F.
authors.forename: Manuel
authors.initials: M
authors.lastname: Baños-González
authors.forename: Carlos
authors.initials: C
authors.lastname: Cantú-Brito
authors.forename: Erwin
authors.initials: E
authors.lastname: Chiquete
authors.forename: Antonio
authors.initials: A
authors.lastname: Arauz
authors.forename: José Luís
authors.initials: JL
authors.lastname: Ruiz-Sandoval
authors.forename: Jorge
authors.initials: J
authors.lastname: Villarreal-Careaga
authors.forename: Fernando
authors.initials: F
authors.lastname: Barinagarrementeria
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Lozano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D020521:Stroke / Q000503:physiopathology*; D013997:Time Factors; D055815:Young Adult