Relationship between acute blood pressure and prognosis in different subtypes of first ischemic stroke
10.3760/cma.j.issn.1673-4904.2013.13.001
- VernacularTitle:不同病因首次缺血性脑卒中急性期血压与预后的关系
- Author:
Chuanqing YU
;
Mei ZHANG
;
Lei ZHU
;
Liang YU
- Publication Type:Journal Article
- Keywords:
Stroke;
Brain ischemia;
Blood pressure;
Prognosis
- From:
Chinese Journal of Postgraduates of Medicine
2013;(13):1-5
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the variation of acute blood pressure in different subtypes of first ischemic stroke,and investigate the influence on the prognosis.Methods A total of 710 patients with first ischemic stroke were selected.The blood pressure levels were monitored during the initial 7 hospital days.Clinical outcome was based on the combined analysis of Barthel index and the National Institute of Health Stroke Scale (NIHSS) score on the 180th day.In the subtypes of large artery atherothrombosis(LAA),cardioembolism (CE),small artery disease occlusion (SAO) were 400,160,150 cases.Logistic regression model was used to estimate the influencing factors on the prognosis.Results An U-shaped effect was observed in different subtypes between blood pressure on admission,average acute blood pressure and prognosis.In the subtypes of LAA and CE,those who had a basehne systolic blood pressure (SBP) of 140-159 mm Hg (1 mm Hg =0.133 kPa) or a baseline diastolic blood pressure (DBP) of 90-99 mm Hg on admission got good prognosis.In the subtypes of SAO,those who had a baseline blood pressure of 130/95 mm Hg on admission got good prognosis.In all subtypes,the average blood pressure of 150/95 mm Hg got good prognosis.In the subtypes of LAA and CE,those who had a baseline SBP of 120-159 mm Hg or a baseline DBP of 80-99 mm Hg within 7 d after admission got good prognosis.In the subtypes of SAO,those who had a baseline blood pressure of 140/90 mm Hg within 7 d after admission got good prognosis.In all subtypes,the average blood pressure of 140/90 mm Hg within 7 d after admission got good prognosis.Logistic regression analysis revealed that the decrease of blood pressure during the first 24 hours,deterioration within 7 d after admission,acute complication,NIHSS score on admission were the independent risk factors of prognosis,while antihypertensive therapy in the acute phase was the independent protection factor in the subtypes of LAA and CE.In the subtypes of SAO,acute complication was the independent risk factor of prognosis.Conclusions An U-shaped effect is observed in different subtypes between blood pressure on admission and prognosis.In the subtypes of LAA and CE,the decrease of blood pressure during the first 24 hours,deterioration within 7 d after admission,acute complication,NIHSS score on admission are the independent risk factors of prognosis.
