title: Change in Systolic Blood Pressure During Stroke, Functional Status, and Long-Term Mortality in an Elderly Population.
abstract: BACKGROUND
  Elevated systolic blood pressure (SBP) recorded by 24-hour blood pressure monitoring (24H BPM) on the first day of acute stroke is associated in elderly patients, with an unfavorable outcome. Herein, we assessed, by 24H BPM, the impact of the change in SBP levels during the first week of stroke on short-term functional status and long-term mortality in elderly patients.
  
  
  METHODS
  One hundred and fifty acute stroke patients (69 males), mean age at admission 83.6±5.5 years, 82% with ischemic stroke, were investigated. 24H BPM was recorded within 24 hours of admission and 1 week later. After 7 days, patients were assessed for functional status according to the modified Rankin scale (mRS) and were subsequently followed for mortality up to 7.5 years (mean 3.16±2.29).
  
  
  RESULTS
  After 7 days, SBP decreased from 147±21 to 140±20 mm Hg (P < 0.001). Functional status improved and mRS decreased from 4.2 to 3.7. During follow-up, 58 patients (17 males and 41 females) had died. Mortality rate was higher in females (69% vs. 45%; P < 0.01) and in patients with a history of congestive heart failure. The average admission SBP predicted short-term functional status and long-term mortality. However, the change in SBP corrected for admission levels, gender, age and other variables was not associated with short-term functional status and long-term mortality.
  
  
  CONCLUSIONS
  There is no evidence of association between change in SBP during the first week of stroke and short-term functional status and long-term mortality in this group of stroke patients.
authors.affiliation: Geriatric Ward, Rabin Medical Center, Petach Tikvah, Israel;
authors.forename: Avraham
authors.initials: A
authors.lastname: Weiss
authors.affiliation: Geriatric Ward, Rabin Medical Center, Petach Tikvah, Israel;
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
authors.affiliation: KPA and University of Turin, Italy;
authors.forename: Ron S
authors.initials: RS
authors.lastname: Kenett
authors.affiliation: Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to Sackler School of Medicine, Tel-Aviv University, Israel. grosse@tauex.tau.ac.il.
authors.forename: Ehud
authors.initials: E
authors.lastname: Grossman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology*; D008297:Male; D020127:Recovery of Function; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: acute phase stroke; blood pressure; change in blood pressure; elderly; functional status; hypertension; morbidity; mortality.