Effect Of Antihypertensive Therapy In Acute Stage Of Ischemic Stroke On Post-stroke Cognitive Impairment

Objective To explore the relationship between antihypertensive therapy and cognitive impairment after stroke in patients with acute ischemic stroke.Methods Acute ischemic stroke patients admitted to the Department of Neurology in the Affiliated Hospital of North China University of Science and Technology from January 2019 to October 2020 were collected.Based on diagnostic criteria,inclusion criteria and exclusion criteria.A total of 167 patients were selected.Number the subjects in turn,draw lots for groups.The intervention group was 84 cases,control group 83.The intervention group was given antihypertensive treatment within 24 hours after randomized grouping,and the systolic blood pressure was reduced by 10%-20%(average reduction was 15%).The blood pressure was controlled within 7 days and maintained at the same level thereafter.The control group did not implement antihypertensive treatment in principle.All subjects were evaluated at 14 days after randomization/discharge,3months,and 6 months after randomization,and cognitive impairment after stroke was recorded.Statistical indicators were used to compare the differences between the two groups.Kaplan-Meier method was used to calculate the incidence of cumulative events and draw curves.Results 1 There was no statistical difference in baseline condition between the two groups(P>0.05).2 For 3 months,The total score of Mo CA in the antihypertensive group(26.47±1.39)was higher than that in the non-hypertensive group(26.02±1.80),a statistical difference(P<0.05).For 6 months,The total score of Mo CA in the antihypertensive group(28.21±1.03)was higher than that in the non-hypertensive group(27.41±1.49),a statistical difference(P<0.05).For 3 months,The total MMSE score(27.53±1.44)in the antihypertensive group was higher than that in the non-hypertensive group(27.04±1.83),a statistical difference(P<0.05).For 6 months,The total score of MMSE in the antihypertensive group(29.09±1.19)was higher than that in the non-hypertensivel group(28.25±1.63),a statistical difference(P<0.05).3 The scores of each sub-domain of the Mo CA、MMSE scale were statistically significant(P<0.05).4MOCA score and MMSE score at 3 and 6 months were both higher than those at 14days/discharge score in 2 groups;There was also an improvement at 6 months compared with 3 months.5 Multivariate Logistic regression analysis showed that patients receiving antihypertensive therapy had a reduced risk of cognitive impairment after 3 months of stroke(OR=0.340,95%CI:0.124-0.931,P=0.036).The risk of cognitive impairment after6 months of stroke was also reduced(OR=0.041,95%CI:0.002-0.723,P=0.029),with a statistically significant difference(P<0.05).6 Antihypertensive therapy reduced the mortality/dependency ratio for 3 months and 6 months(P<0.05).7 Antihypertensive therapy decreased the incidence of adverse events at 6 months(P<0.05).Conclusions Antihypertensive therapy can reduce the risk of cognitive impairment after 3 and 6 months of stroke,and it has certain clinical application value to implement antihypertensive therapy in the acute stage of ischemic stroke.Figure 2;Table 21;Reference 141...