title: A Fall in Systolic Blood Pressure 24 Hours after Thrombolysis for Acute Ischemic Stroke Is Associated with Early Neurological Recovery.
abstract: BACKGROUND
  Outcomes are worse in patients who underwent thrombolysis for acute ischemic stroke (AIS) with persistent hypertension. The objective of this study is to investigate whether fall in systolic blood pressure (SBP) has any relationship with neurological outcome 24 hours after thrombolysis, after adjusting for potentially confounding factors.
  
  
  METHODS
  Retrospective analysis of a single-center database of consecutive thrombolysis cases for AIS. Multivariate regression analysis was used to explore the relationship between fall in SBP and reduction in National Institutes of Health Stroke Scale (NIHSS) score 24 hours after thrombolysis. Other potentially confounding predictor variables used in the model were SBP on thrombolysis, blood glucose level on thrombolysis, NIHSS score on thrombolysis, administration of antihypertensive medications, and the time to thrombolysis after symptom onset.
  
  
  RESULTS
  A fall in SBP 24 hours after thrombolysis is independently associated with greater improvement in NIHSS score 24 hours after thrombolysis (coefficient .051, 95% confidence interval .023-.078, P < .001). Thus, a reduction of 10 mmHg in SBP after 24 hours is associated with a .51 point reduction in the NIHSS score.
  
  
  CONCLUSIONS
  Restoration of SBP toward normal limits after thrombolysis for AIS is associated with greater early neurological improvement.
authors.affiliation: Imperial College London, London, United Kingdom. Electronic address: dipender.gill@imperial.ac.uk.
authors.forename: Dipender
authors.initials: D
authors.lastname: Gill
authors.affiliation: Barts Health NHS Trust, London, United Kingdom.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cox
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Adarsh
authors.initials: A
authors.lastname: Aravind
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Wilding
authors.affiliation: Imperial College, College London, London, United Kingdom.
authors.forename: Eleni
authors.initials: E
authors.lastname: Korompoki
authors.affiliation: Department of Stroke Medicine, Division of Brain Sciences, Imperial College London, London, United Kingdom.
authors.forename: Roland
authors.initials: R
authors.lastname: Veltkamp
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Arindam
authors.initials: A
authors.lastname: Kar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D007262:Infusions, Intravenous; D008131:London; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013599:Systole; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Blood pressure; cerebral infarction; hypertension; ischemic stroke; rtPA; tPA; thrombolysis