Study Of Blood Pressure Variation And The Relationship Between Blood Pressure And Prognosis In Patients With Acute Stroke

Study of blood pressure variation and independent factors related to BP levels of patients with acute strokeObjective: To explore the blood pressure variation and influential factors in patients with acute strokeMethod: We studied 342 consecutive inpatients admitted within the first 24 hours after the onset of stroke. we collected the basic information ,monitored the blood pressure values during the first 7 hospital days ,graded the companion diseases ,recorded the ways and the time of managing blood pressure .The data was analysed with SAS statistic software .Result:(1) Blood pressure elevated in initial stage of acute stroke .it decreased distinctively during the first 16 hours, especially the first 4 hours, and changed smoothly from 16 hours to 48 hours after admission,P<0.05.(2) Blood pressure in acute stage of brain infarction was higher than that of cerebral hemorrhage .(3) Blood pressure of stroke patients with hypertension history was higher than that of normotensive patients in acute stage .(4) Blood pressure variation had no difference among five brain infarction subgroups.(5)Multiple linear regression analysis revealed that stroke type, history of hypertension and scores of companion diseases were positively related with mean blood pressure ,while scores of anamnesis were negatively related with mean diastolic blood pressure (DBP) in patients with acute stroke .Conclusion: Blood pressure usually elevated in patients with acute stroke , it decreased distinctively during the first 16 hours, and changed smoothly from 16 hours to 48 hours after admission. Blood pressure was higher in those patients who were cerebral hemorrhage, who had hypertension previously and more companion diseases than others at acute stage of stroke .Part 2 Study of the relationship between blood pressure and prognosis in patients with acute strokeObjective: To explore the relationship between blood pressure and prognosis in patients with acute stroke and provide guidance for clinical treatment .Method: We studied 342 consecutive inpatients admitted within the first 24 hours after the onset of stroke. we collected the basic information ,monitored the blood pressure values during the first 7 hospital days ,graded the companion diseases ,recorded the ways and the time of managing blood pressure Stroke severity was measured with National Institutes of Health Stroke Scale (NIHSS) on admission ,at the 14-day and 6-month visits. The functional outcome was assessed on the basis of mortality or dependency (Barthel Index ,BI <60)at the 30-day and 6-month visits. The data was analysed with SAS statistic software.Result: (1)A U-shaped relationship was found between BP on admission, as well as mean BP during the first 7 days ,and functional outcome at the 30-day and 6-month visits. Those who had a BP of 150/85mmHg would have a better functional outcome, those who had higher or lower BP would have a poor functional outcome. (2)Atherothrombotic infarction and cardioembolic infarction had a better functional outcome when BP on admission was 120-180/70-100mmHg. Functional outcomes varied slightly among different mean BP interzones of the the first 2 days and the first 7 days. Datas of lacunar infarction, other etiology infarction and unknown etiology infarction could not be analysed because of small samples. (3)Functional outcomes of cerebral hemorrhage at 6-month visits were better when SBP on admission varied from 120 to 180 mmHg .the lower mean SBP of the first 7 hospital days, the better functional outcomes at 6-month visits. DBP on admission and mean DBP of the first 7 hospital days were not related with functional outcomes at 6-month visits. (4)Differences of NIHSS between admission and 14 days after admission were not notable in antihypertensive groups within 2days and 3 days after admission and control group, differences of NIHSS between admission and 6 months after admission were the same. Antihypertensive therapy had no influence on the improvement of NIHSS scores. (5)Multiple linear regression analysis revealed that scores of companion diseases ,deterioration within 3 days after admission and DBP decreasing more than 20% were positively related with scores of NIHSS at 6 months after admission, while antihypertensive therapy after admission were negatively related with scores of NIHSS at 6 months.Conclusion:A U-shaped relationship was found between BP and prognosis in patients with acute stroke . Prognosis was better when SBP varied from 120 to 180mmHg and DBP varied from 70 to 100mmHg.When studied according to stroke type and brain infarction subtype ,we can speculate that high BP was advocated to decrease placidly in patients of cerebral hemorrhage ,while no conclusion can arrived because of small samples in patients with acute brain infarction and a further research was needed.