Blood pressure and antihypertensive therapy as predictors of early outcome in acute ischemic stroke

Cerebrovascular Diseases
Mark R KeezerRobert Côté

Abstract

The clinical impact of blood pressure (BP) and of antihypertensive therapy (AHT) in acute ischemic stroke remains uncertain. We reviewed the charts of patients admitted to the Montreal General Hospital between April 1, 2002 and October 15, 2005. Ischemic stroke was considered severe if the Canadian Neurological Scale at presentation was < or =7. Poor outcome at 10 days after onset was defined as a modified Rankin Scale >3. Acute change in BP was defined as the percent difference between the mean 24-hour mean arterial pressure (MAP) and the baseline MAP. AHT was considered present if administered > or =5 days during the first week after stroke onset. The association between predictors and outcome was assessed using unconditional multivariable logistic regression. Covariates used included age, stroke severity, diabetes mellitus, coronary artery disease, atrial fibrillation, premorbid hypertension and hyperlipidemia. Three hundred and sixty-four patients were included. Compared to patients with intermediate baseline BP, those with a MAP >130 mm Hg [OR = 2.47 (95% CI, 1.04-5.85)] or a MAP <90 mm Hg [OR = 2.94 (95% CI, 1.28-6.77)] were found to have an increased risk of poor outcome after covariate adjustment. A 15% increase in MAP ...Continue Reading

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Feb 23, 2013·International Journal of Hypertension·Simona LattanziLeandro Provinciali
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