Stuty Of The Effect Of Antihypertension Treatment On Prognosis In Patient With Acute Cerebral Infraction

Objectives1To explore the effect of antihypertensive treatment on long-termprognosis with acute cerebral infarction patients.2To explore the effect of different bloodpressure descend range on long-term prognosis with acute cerebral infarction patients.Methods452cases who had ischemic stroke within48hours of symptoms onset for thefirst time with elevated blood pressure were collected.Patients were recruited fromDepartment of Neurology in Affiliated Hospital of Hebei United University betweenAugust2009and May2013.Patients were randomly assigned to intervention group andcontrol group.Collecting the basic data and dynamical monitoring blood pressure ofpatients within14days or during hospitalization.Patients in intervention group receivedantihypertensive treatment.Blood pressure were lowered by10%to20%within the first24hours,however,blood pressure level was higher than120/80mmHg.At the7thday,blood pressure achieved to less than140/90mmHg,maintaining this level betweenthe7th to14th day. In principle,the control group was not given antihypertensivetherapy.Prognosis was followed up.At3months and1year, Modified Rankin scale(mRS)and the United States national institutes of health stroke scale (NIHSS)was used toevaluate the patients’ self-care ability of life and neurologic function defectdegree,besides,death and recurrence were recorded.In the study outcome,death or lifedependence was defined as Modified Rankin’s scale (mRS)≥3.Effective treatment wasdefined as the number of functional recovery,significant progress and progress dividedthe total number of each group multiplied by100%.Statistic analysis was conductedusing SPSS13.0software.Difference of the baseline characteristics and prognosis in thetwo groups were compared. Single factor and multiple logistic regression model was usedto analysis the relationship among acute cerebral infarction antihypertensive treatmentand blood pressure change extent with prognosis,which were evaluated by the relativeratio (RR) and95%confident interval (95%CI).Results1There were no difference in characteristic of basic data(includinggender,age,blood pressure and so on),except disease time and hospitalized systolicpressure.It showed that the basic date in the two groups was essentially comparable.2Themortality and recurrence rate in intervention group was lower than that in the control group at3months and1year,but there was no statistically significant difference.3Thedeath and major disability rate in intervention group and in the control group at3monthsand1year had no obvious statistical significance.After adjustment for somefactors,multivariable logistic regression analysis showed that the treatment had noobvious effect on prognosis (P>0.05).The treatment efficiency (including basicrecovery,remarkable progress rate and rate of progress) in control group was slightlyhigher than that in the intervention group, but there was no statistically significantdifference between the two groups (P>0.05).4SBP descend range in the first24hours inintervention group was divided into (10%~15%) group and (15%~25%) group. Takingthe descend range (10%~15%) as a reference, the single factor logistic regressionanalysis showed that at3months and1year, although the two groups had no statisticallysignificant difference (P>0.05), but risk of death or life dependent in descend range(15%~20%)group was higher than the (10%~15%) group.Conclusions1Antihypertensive therapy had no influence on mortality and recurrencerate at3months and1year in patients with acute cerebral infarction.What’s more,itnether influence death or life dependence and neural functional recovery.2Inantihypertensive treatment group,SBP descend range in the first24hours have no effecton death or life dependence with acute cerebral infarction patients at3months and1year.