Blood pressure change and outcome in acute ischemic stroke: the impact of baseline values, previous hypertensive disease and previous antihypertensive treatment.

Details

Serval ID
serval:BIB_11D2F4099ECF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Blood pressure change and outcome in acute ischemic stroke: the impact of baseline values, previous hypertensive disease and previous antihypertensive treatment.
Journal
Journal of Hypertension
Author(s)
Ntaios G., Lambrou D., Michel P.
ISSN
1473-5598 (Electronic)
ISSN-L
0263-6352
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
29
Number
8
Pages
1583-1589
Language
english
Abstract
BACKGROUND: Management of blood pressure (BP) in acute ischemic stroke is controversial. The present study aims to explore the association between baseline BP levels and BP change and outcome in the overall stroke population and in specific subgroups with regard to the presence of arterial hypertensive disease and prior antihypertensive treatment.
METHODS: All patients registered in the Acute STroke Registry and Analysis of Lausanne (ASTRAL) between 2003 and 2009 were analyzed. Unfavorable outcome was defined as modified Rankin score more than 2. A local polynomial surface algorithm was used to assess the effect of BP values on outcome in the overall population and in predefined subgroups.
RESULTS: Up to a certain point, as initial BP was increasing, optimal outcome was seen with a progressively more substantial BP decrease over the next 24-48 h. Patients without hypertensive disease and an initially low BP seemed to benefit from an increase of BP. In patients with hypertensive disease, initial BP and its subsequent changes seemed to have less influence on clinical outcome. Patients who were previously treated with antihypertensives did not tolerate initially low BPs well.
CONCLUSION: Optimal outcome in acute ischemic stroke may be determined not only by initial BP levels but also by the direction and magnitude of associated BP change over the first 24-48 h.
Pubmed
Web of science
Create date
05/10/2011 10:00
Last modification date
20/08/2019 12:39
Usage data