title: Hypertension at time of diagnosis and long-term outcome after childhood ischemic stroke.
abstract: OBJECTIVE
  To determine the prevalence of hypertension (HPT) in the acute phase after ischemic stroke (IS) and explore its relationship to outcome.
  
  
  METHODS
  We performed a retrospective review of children aged 1 month to 18 years with first IS admitted to a tertiary hospital between 2003 and 2008. Blood pressure readings recorded over the first 72 hours after diagnosis and morbidity or mortality at 12 months were documented. HPT was defined as 2 consecutive readings of systolic blood pressure ≥95th percentile for age.
  
  
  RESULTS
  Ninety children were identified (median age 3.8 years). Fifty-three of 84 patients (63%) who had blood pressure readings available had at least 1 episode of HPT and 19 (22%) had HPT on 3 consecutive days. HPT was more prevalent at both ends of the age spectrum. The relative risk of 12-month mortality was 4.5 times higher (95% confidence interval = 0.6-34.5, p = 0.096) and relative risk of death in the hospital was 1.7 times higher (95% confidence interval = 1.4-2.0, p = 0.05) if the patient experienced HPT. There was no association between HPT and vascular territory, etiology, or neurologic disability.
  
  
  CONCLUSIONS
  HPT is prevalent in children with IS in the first 3 days after diagnosis and is associated with increased risk of death. Larger prospective studies involving systematic recording of blood pressure are required to delineate the impact of HPT on risk of death or disability.
authors.affiliation: School of Medicine, University of Melbourne, Australia.
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Brush
authors.forename: Paul T
authors.initials: PT
authors.lastname: Monagle
authors.forename: Mark T
authors.initials: MT
authors.lastname: Mackay
authors.forename: Anne L
authors.initials: AL
authors.lastname: Gordon
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D002545:Brain Ischemia / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D007223:Infant; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome