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
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