Associations between variation of systolic blood pressure and neurological deterioration of ischemic stroke patients
- Author:
Cheung-Ter Ong
;
How-Ran Guo
;
Kuo-Chun Sung
;
Chi-Shun Wu
;
Sheng-Feng Sung
;
Yung-Chu Hsu
;
Yu-Hsiang Su
- Publication Type:Journal Article
- From:Neurology Asia
2010;15(3):217-223
- CountryMalaysia
- Language:English
-
Abstract:
Objectives: To assess the relationship of variation of blood pressure and neurological deterioration
(ND) in ischemic stroke patients. Methods: We recruited patients with the fi rst-ever ischemic stroke
at a teaching hospital. The National Institutes of Health Stoke Score (NIHSS) of each patient was
monitored for 2 months. ND was defi ned as an increase of ≥ 2 points in NIHSS during the fi rst 7
days after stroke. Blood pressure was measured every 6 hours for fi rst 7 days. We analyzed blood
pressure data in the fi rst 36 hours to study the relationship between variation of blood pressure and
ND. Successive variation of systolic (svSBP) and diastolic (svDBP) blood pressure was calculated
as svSBP= |SBPn+1 – SBPn
| and svDBP= |DBPn+1 – DBPn
| respectively. The largest svSBP in the
fi rst 36 hours of hospitalization or before ND was defi ned as maximum variation of systolic blood
pressure (maxvSBP). Then, the mean variation of systolic (mvSBP) and diastolic (mvDBP) blood
pressure was calculated as mvSBP= svSBP/N and mvDBP= svDBP/N respectively. Results: A total
of 121 patients were included in this study, and 38 of them had ND. The mvSBP was higher in the
ND Group (17.9±8.4 mmHg vs. 13.7±4.4 mmHg, p=0.006) but the difference in mvDBP did not
reach statistical signifi cance (9.8±3.5mmHg vs. 8.6±3.0 mmHg p=0.06). The ND Group had a larger
maxvSBP (35.2±17.2 vs. 27.6±11.6 mmHg, p =0.01), which was more frequently over 30mmHg than
that in the stable group (P=0.02).
Conclusions: A large svSBP is associated with an increased risk for ND. The study highlights the
importance of close monitoring of blood pressure in ischemic stroke patients.
- Full text:P020150902418396290734.pdf
