The Effect Of Blood Pressure Reduced On Prognosis In Acute Ischemic Stroke

Objective 1.To investigate the blood pressure variation and the relationship between blood pressure levels and prognosis in patients with actue ischemic stroke.2.To study the different factors effecting the prognostic of ischemic stroke patients.Method The 1150 cases of ischemic stroke patients were admitted from the First,Second,Third and Fourth Affiliated Hospital of Baotou Medical College in October 2011 to April 2014,which basis the onset time within 24 hours and a clear imaging.According to blood pressure values??or without antihypertensive treatment,it was measured blood pressure in the hospital.In accordance with China Stroke guide line,the blood pressure levels divided into four groups,such as SBP<140mmHg,140 mmH ≤ SBP<159mm Hg,160 mmHg ≤SBP<179mmHg,SBP≥180mmHg.To measure blood pressure every 8 hours within 7days in the hospital and at least three times and study the death/disability rate and relapse rate of 3,6month,it was assess the prognosis of ischemic stroke patients.Results 1.The blood pressure rises modestly on first day,it was declined slowly on second to firth day and stabilizes on sixth to seventh day in patients with ischemic stroke.2.The compared with blood pressure <l40mmHg,160-179 mmHg and 180 mmHg between140-159 mmHg,there are respectively in Six months of death / disability or values of relative riskwas 1.982,1.782 and 3.12.The six months recurrence rate risk of blood pressure <l40mm Hg,(160-179)mm Hg,is equal to or larger than 180 mmhg six months were respectively the times 2.118、1.739 and 1.919 in the level of blood pressure(140-159)mmHg,3.According to TOAST the relative risk of death/disability rate was 0.376 in LAA subtype patients when blood pressure is 160-179 mmHg,which were statistically significant differences compared with other blood pressure groups(P<0.05).The relative risk of death/disability rate in CE subtype and other blood group is 3.244,2.091,and 2.300 times than blood pressure of 140-159 mmHg.The relative risk of death/disability rate in SAO subtype and other blood group are 0.937,0.837,and1.160 than blood pressure of140-159 mmHg,which were statistically significant differences(P<0.05).4.It is may increase death/disability rate of ischemic stroke patients in age,hypertension,smokingand total cholesterol,which the relative risk are 4.233,1.955,1.095 and 1.644 times and the difference is statistically significant(P<0.05).The recurrence rate of ischemic stroke can increase in family history of stroke,history of smoking,hypertension and high cholesterol,which the relative risk is 2.72,3.37,1.95 and 1.5times and the difference is statistically significant(P<0.05).Conclusions 1.The variation of blood pressure in ischemic stroke patients presents are rising and then decrease.2.Acute blood pressure levels and prognosis in patients with ischemic stroke is U-Shaped relationship,the best prognosis is blood pressure 140-159 mmHg.Different causes of ischemic stroke patients prognosis is differ from at different levels of blood pressure.In TOAST types,the best prognosis is blood pressure 160-179 mmHg in LAA subtype and the worst prognosis is blood pressure <140mmHg.The best prognosis is blood pressure <140mmHg in CE subtype,the worst prognosis is blood pressure ≥180mmHg.The prognosis at different blood pressure of SAO subtype is similar.5.It is major risk factors for prognosis of ischemic stroke patients in age,hypertension,high cholesterol and smoking are.