The Characteristics Of Ambulatory Blood Pressure In Acute Ischemic Stroke And Its Relationship With Prognosis

Background:Although stroke treatment guidelines agreed with the extreme importance of management of hypertension patients with cerebral stroke, but the clinical role of ambulatory blood pressure monitoring in cerebrovascular disease has not been valued.Objective:1. Monitoring of acute ischemic stroke in patients blood pressure and blood pressure circadian rhythm changes;2. To discuss the correlation between blood pressure and blood pressure circadian rhythm and prognosis in patients with ischemic stroke acute phase.Methods:We analyzed54cases of acute ischemic stroke in patients with24hours ambulatory blood pressure monitoring. In the second day and on the eighth day after admission (i.e., the first day and seventh day) using dynamic blood pressure monitoring, record the average of24-hour blood pressure, the average of daytime blood pressure, the average of night blood pressure and the maximum blood pressure, the minimum blood pressure and blood pressure circadian rhythm. MRS was used to assess the prognosis of cerebral stroke3months, score2or less as independent (the good prognosis), a score of3or more as a dependent (the bad prognosis). we compare with blood pressure change on the first and the seventh day. We analyze the correlation between blood pressure, blood pressure circadian rhythm and prognosis.Results:40patients (74.1%) gained independence,14patients (25.9%) gained dependent. We gain significant statistical difference (P<0.01) by camparing with the first and the seventh day of24hours mean blood pressure、daytime average systolic/diastolic blood pressure、nighttime average systolic/diastolic blood pressure、the highest and lowest systolic/diastolic blood pressure in acute Ischemic stroke. The blood pressure circadian rhythm between the first day and the seventh day is no statistical difference (P>0.05). The blood pressure in two groups with different Prognosis is no statistical difference between (P>0.05). The two different Prognosis groups with blood pressure circadian rhythm was statistically difference (P<0.05).Conclusion:1. The blood pressure of acute ischemic stroke has a spontaneous downward trend. The24hours average systolic/diastolic blood pressure、daytime average systolic/diastolic blood pressure、nighttime average systolic/diastolic blood pressure、the highest systolic/diastolic blood pressure、 the lowest systolic/diastolic blood pressure between the first day and the seventh day are statistically significant (P<0.01). The blood pressure circadian rhythm between the first day and the seventh day is no statistical difference. Therefore, The treatment of blood pressure in ischemic stroke acute phase need to be careful, don’t need to be active treatment.2. Prognosis of ischemic stroke3months of the different between the two groups of blood pressure circadian rhythm is statistically significant (P<0.05) and prognosis of different blood pressure is no statistical difference between the two groups. Therefore, in antihypertensive treatment on the ischemic stroke acute phase at the same time we control of the nighttime blood pressure effectively, which can maintain blood pressure circadian rhythm to help to prognosis of ischemic stroke.