| Background : Ischemic stroke and hemorrhagic stroke are two pathological subtypes of stroke with different risk factors and pathogenesis, it is probably different that effect of various risk factors on different subtype stroke. However, most of studies did not differentiate stringently ischemic stroke from hemorrhagic stroke. High blood pressure (BP) is the most important modifiable risk factor for the incidence of stroke. However, the relationship between BP and clinical outcome (i.e., death or disability) among acute stroke patients is much less certain.Objective : The purpose of the present study is to compare difference for risk factors between ischemic and hemorrhagic stroke, to examine association between admission BP and in-hospital death or disability among acute stroke patients, so as to provide scientific basis for BP management and treatment.Methods: A total of 2,178 acute ischemic stroke and 1,760 hemorrhagic stroke patients in six hospitals from January, 2003 to December, 2005 were included in the present study. Demography information, life style factors, BP levels, blood examinations, medical record at admission and clinical outcomes during hospitalization were collected by trained staffs. Comparisons of risk factors between ischemic and hemorrhagic stroke were conducted by using single factor analysis method, the associations between admission BP and the risk of in-hospital death and disability were analyzed by using multiple logistic model.Results : The rates of smoking (24.2%)and diabetes history (11.3%)were higher for acute ischemic stroke patients compared with acute hemorrhagic stroke patients (20.3%,6.6%),all P<0.01. The TC, TG levels of acute ischemic stroke were higher than those of hemorrhagic stroke patients (TC:5.14±1.184 vs 5.00±1.164; TG:1.82±1.388 vs 1.65±1.581 ), all P<0.05.The rates of alcohol drinking(21.7%), hypertension history (58.0%)and family history of cardiovascular disease (6.6%) were higher for acute hemorrhagic stroke patients compared with acute ischemic stroke patients (20.6%,54.8%,5.0%). SBP/DBP levels of acute hemorrhagic stroke patients were higher than that of acute ischemic stroke patients(SBP: 172.3±34.6 vs 152.1±28.9; DBP:103.9±19.5vs 92.0±16.8), all P<0.01.The blood glucose level of acute hemorrhagic stroke patients was higher than that of acute ischemic stroke patients (7.09±2.956 vs 6.69±3.221),P<0.01.The disability rate was higher for those with acute ischemic stroke (41.3%) compared with acute hemorrhagic stroke (34.4%). The case-fatality rate was higher for acute hemorrhagic stroke (5.9%) than it was for acute ischemic stroke (1.8%).SBP was significantly and positively as sociated with risks of death or disability in acute hemorrhagic stroke. For example, compared to those with a SBP<140 mmHg, multivariate-adjusted OR of disability was 1.500, 1.625 and 1.898 among participants with SBP140~159, 160-179 and≥180 mmHg, respectively, all P<0.05. Multivariate-adjusted OR of death was 2.069 among participants with SBP≥180 mmHg, P<0.01.DBP was significantly and positively associated with risks of death or disability in acute hemorrhagic stroke. For example, compared to those with DBP<90 mmHg, multivariate-adjusted OR of disability was 1.459(P=0.051),1.634(P<0.01)and1.687(P<0.01)among participants with DBP 90~99, 100-109 and≥110mmHg, respectively. Multivariate-adjusted OR of death was 2.569 among participants with DBP≥110 mmHg, P<0.05.SBP/DBP at admission were not significantly associated with clinical outcome in acute ischemic stroke, P<0.05.Conclusion: Smoking, diabetes history, hyperlipidemia could be more associated with ischemic stroke compared with hemorrhagic stroke; alcohol drinking, family history of cardiovascular disease and hypertension could be more associated with hemorrhagic stroke compared with ischemic stroke. SBP/DBP at admission were significantly and positively associated with risks of death or disability in acute hemorrhagic stroke, but not in acute ischemic stroke.
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