The role of daily blood pressure monitoring parameters and its variability in predicting of an acute ischemic stroke outcome
Journal Title: Український неврологічний журнал - Year 2018, Vol 0, Issue 1
Abstract
Objective — to investigate the association between the ascending neurological deficit and outcome of acute stage of ischemic stroke in patients with hypertension and the daily blood pressure (BP) monitoring parameters and its variability. Methods and subjects. 150 patients with initial ischemic stroke and history of arterial hypertension (AH) have been examined: 74 (49.3 %) females and 76 (50.7 %) males, mean age — 67.4 ± 0.7 years. Neurological deficit was evaluated by NIHSS scale. The diagnosis of hypertension was based on clinical, instrumental examination and medical documentation data. Daily blood pressure monitoring was used on admission and every 4 hours during 6 days of acute stroke stage. Mean SBP, mean DBP, maximum SBP and DBP, standard deviation (SD) of SBP and DBP were studied. Results. The severity of neurological deficit was 9.5 ± 0.4 points and correlated with the duration of AH anamnesis, r = 0.540 (p = 0.001). After 8, 12, 16, and 20 hours of stroke onset, the mean values of SBP and SD SBP were significantly higher in case of more severe stroke. The highest value of SD of SPB was found at the first day — 18.7 ± 0.7 mm Hg. during the period of the first three days (18.9 ± 0.5 mm Hg). The strongest correlations of the NIHSS score at the end of the acute stroke stage were observed with the SD of SBP and SD of DBP during the period from 1 — 3 days, including the results of daily blood pressure monitoring (r = 0.725) and (r = 0.550), respectively, SD of SBP for 24 hours (r = 0.478) and duration of AH (r = 0.538). Singlefactor regression analysis has established the association (R2 = 0.526) between stroke severity by NIHSS at discharge and SD of SBP for a period from 1 — 3 days. Conclusions. In patients with ischemic stroke against the background of hypertension, the acute stage stroke outcome correlates with variability parameters of daily blood pressure monitoring (SD of SBP and SD of DBP for period 1 — 3 days, SD of SBP for 24 hours) and AH duration. The probability of a 50 % NIHSS point regression is predicted in the case of SD of SBP during 1 — 3 days less than 12.4 mm Hg.
Authors and Affiliations
T. M. Cherenko, Yu. L. Heletyuk
Keywords
Related Articles
- EP ID EP292059
- DOI -
- Views 110
- Downloads 0
Clinical and brain bioelectric features in patients with acute recurrent cerebral hemispheric ischemic stroke depending on acute disease period outcome
Objective — to study clinical‑neurophysiological correlations in patients with recurrent cerebral hemispheric ischemic stroke (RCHIS) depending on the outcome of the acute period of the disease. Methods and subjects. Co...
Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes: modern views on the problem
The article discusses the main aspects of the etiology of mitochondrial disorders, where the key factor is mutations in mitochondrial and nuclear DNA. The most common variants of mutations that cause the development of t...
The state and ways of improvement of health care for patients with cerebral stroke in Kyiv
Objective — to improve the quality of medical care for patients with cerebral stroke. Methods and subjects. The study included an examination of 1575 patients with acute cerebral stroke (males 42.7 %) aged 26 to 100 yea...
Myotonic dystrophy. Clinical case
The article presents modern issues on etiopathogenesis, classification, typical clinical signs, diagnostic algorithm and treatment approaches for myotonic dystrophy. The actual clinical case is described in the article.
Characteristics of the clinical course of ischemic stroke against the background small vessel disease
Objective — to study the clinical course and functional recovery of patients with various pathogenetic subtypes of ischemic stroke (IS) in small vessel disease (SVD). Methods and subjects. We performed a cohort prospect...