Blood Pressure Variation And Its Relation With Prognosis Of Acute Ischemic Stroke

Part 1 Study of blood pressure variation and influencing factors relatedto BP levels of patients with acute ischemic strokeObjective: To study the blood pressure variation of patients with acute ischemic stroke and its influencing factors.Methods: We studied 842 patients admitted within the first 24 hours after the onset of stroke and excluded of patients receiving thrombolytic therapy. And then we collected the basic information, graded the companion diseases, recorded the management of blood pressure monitored the blood pressure values during the first 7 days. Then we observed the variation of blood pressure within 7 days after admission, and analyzed its influencing factors. The data was analyzed with SPSS statistic software.Results:(1) Blood pressure elevated in initial stage of acute stroke, and generally fell spontaneously within several days. about 75% admission BP elevated, especially the systolic blood pressure. It decreased distinctively during the first 8 hours, and gradually became stable until 48 hours after admission.(2) In patients with ischemic stroke, the average blood pressure of atherosclerotic cerebral infarction is higher than other subtypes in TOAST type(P<0.05). Blood pressure showed a downward trend after the admission in all types. The trend of atherosclerotic cerebral infarction is smoother than other types.(3) Patients who had previous hypertension had slightly higher SBP than those without previous hypertension, and statistical is meaningful.(P<0.05).(4) Patients who had received anti-hypertensive therapy had higher BP than those without anti-hypertensive therapy(P<0.05).(5) There is no significant relationship between blood pressure and carotid artery lesions(P>0.05).(6) Independent factors related to BP were: age, previous hypertension, scores of companion diseases, admission consciousness and anti-hypertensive therapy.Conclusion: Blood pressure usually elevated in patients with acute ischemic stroke, and there is a spontaneous downward trend latter. Independent factors related to BP were: age, previous hypertension, scores of companion diseases, admission consciousness and anti-hypertensive therapy. Part 2 Study of the relationship between blood pressure and prognosisin patients with acute ischemic strokeObjective: To explore the relationship between blood pressure and prognosis in patients with acute ischemic stroke.Methods: We studied 842 patients admitted within the first 24 hours after the onset of stroke and excluded of patients receiving thrombolytic therapy. And then we collected the basic information, graded the companion diseases, recorded the management of blood pressure monitored the blood pressure values during the first 7 days. 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 mortality or dependency(Barthel Index,BI <60)at the 6-month visits. The data was analyzed with SPSS statistic software.Results:(1) A U-shaped relationship was found between BP and 6 month death and death/dependency, and the admission BP between 150-16-/90-100 mm Hg and mean blood pressure during 7 days between 130-150/70-80 mm Hg had a better prognosis. We find relationship a U-shaped relationship between prognosis and 7-days-MAP, with a litter higher MAP had a better prognosis. Besides we also find a J-shaped relationship between PP and 6 month death/dependency, and the PP between 40-60 mm Hg had a better prognosis. At last, a J-shaped relationship was found between the BP successive variation among the 7 days and 6-month prognosis, a higher BP successive variation, a worse prognosis.(2) Logistic regression analysis revealed that the admission DBP, the mean of SBP during 7 days, SBP successive variation among the 7 days, and the change rate in 24 hours is independent factors in blood pressure. And the whole factors affecting the 6 month prognosis contain admission NIHSS score, companion diseases and exacerbations in 7 days,and the change rate of SBP in 24 hours..Conclusion: A U-shaped relationship was found between BP and prognosis in patients with acute ischemic stroke, and J-shaped relationship between 6 month dependency and BP successive variation during the 7 days. The independent blood pressure factors affecting the 6-month prognosis are the admission DBP, the mean of SBP during 7 days, SBP successive variation among the 7 days, and the change rate in 24 hours.