Change In Blood Pressure And Its Relation With Prognosis Of Acute Stroke

Part 1 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 1005 consecutive inpatients admitted within the first 24 hours after the onset of stroke. And then we monitored the blood pressure values during the first 7days, collected the basic information, graded the companion diseases, recorded the ways and the time of managing blood pressure. The data was analyzed with SPSS statistic software.Results:(1)Blood pressure elevated in initial stage of acute stroke, especially the systolic blood pressure(about 69.13%>140mmHg), It decreased distinctively during the first 8 hours, and gradually became stable until 36 hours after admission.(2) Patients with hemorrhagic stroke had significantly higher SBP and DBP than those with ischemic stroke (P=0.000). After 80 hours the former reached a stable level and the latter after 24 hours. (3) The average systolic blood pressure of atherosclerotic cerebral infarction after higher than the other subtype group in toast type. (4)The one who had took hypotensive medicine daily had the higher BP then the not ones. (5) The SBP successive variation among the 7 days and the degression rate in 24 hours are higher in carotid artery stenosis group of acute stroke than cervical vascular plaque group. (6) Independent factors related to BP were: stroke type, the history of heart disease, hypertension.Conclusion: Blood pressure usually elevated in patients with acute stroke, and decreased gradually. Patients with hemorrhagic stroke had significantly higher SBP and DBP than those with ischemic stroke. Independent factors related to admission BP were: stroke type, heart disease, hypertension, scores of companion diseases. 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.Method: We studied 1005 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 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 and 6-month visits. The functional outcome was assessed on the basis of mortality or dependency(Barthel Index ,BI <60)at the 6-month visits. The data was analysed with SPSS statistic software.Result: (1)A U-shaped relationship was found between BP and 6 month death and death /dependency, especially with the SBP. In the group of cerebral infarction, we found a U- shaped relationship between SBP and 6 month prognosis. While in the group of cerebral hemorrhage, there is a J-shaped relationship. (2)A U-shaped relationship was found between degression rate in 24 hours and prognosis. The rate between 0%~20% had a better prognosis. The higher of successive variation among the 7 days, the worse of the 6-month prognosis. (3) Logist regression analysis revealed that the mean SBP during the first 7 days, MAP during the first 7 days ,the SBP/DBP successive variation among the 7 days, age, scores of companion diseases ,deterioration within 7 days after admissionwere related with high rate of mortality or dependency.Conclusion: A U-shaped relationship was found between BP and prognosis in patients with acute stroke. The degression rate in 24 hours between 0%~20% had a better prognosis. The higher of the successive variation during the 7 days, the worse of the 6-month prognosis. Factors that effects the 6-month prognosis are age, scores of companion diseases, deterioration within 7 days after admission, the mean sBP during the seven days andsuccessive variation.