Is spontaneous normalization of systolic blood pressure within 24 hours after ischemic stroke onset related with favorable outcomes?

In acute ischemic stroke, blood pressure (BP) tends to rise initially and fall to a baseline level within 24-48 hours. Previous studies reported several different effects of BPs during acute ischemic stroke on clinical outcomes, which was partly due to the different time intervals from stroke onset...

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Bibliographic Details
Published in:PloS one 2019-10, Vol.14 (10), p.e0224293-e0224293
Main Authors: Kim, Seo Hyun, Kim, Ji In, Lee, Ji-Yong, Park, Chan Ik, Hong, Jin Yong, Lee, Sung-Soo
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Aged, 80 and over
Blood Pressure
Blood pressure regulation
Brain Ischemia - complications
Cardiac arrhythmia
Discharge
Female
Health aspects
Humans
Hypertension
Independent variables
Intravenous administration
Ischemia
Male
Measurement methods
Medical schools
Medicine
Medicine and Health Sciences
Neurological diseases
Neurology
Patient Admission
Patients
Physical Sciences
Prognosis
Recovery of Function
Regression analysis
Research and Analysis Methods
Stroke
Stroke - complications
Stroke - diagnosis
Stroke - physiopathology
Stroke - therapy
Stroke patients
t-Plasminogen activator
Tissue plasminogen activator
Veins & arteries
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Summary:In acute ischemic stroke, blood pressure (BP) tends to rise initially and fall to a baseline level within 24-48 hours. Previous studies reported several different effects of BPs during acute ischemic stroke on clinical outcomes, which was partly due to the different time intervals from stroke onset to BP measurement. All patients with acute ischemic stroke (onset ≤3 hours) who lived independently before the stroke, were consecutively enrolled for a 62-month period. BPs at 0, 12, and 24 hours after admission were collected. A favorable outcome was defined as a modified Rankin Scale (mRS) score 0-2 at discharge. For different standards of BP management, patients were grouped and analyzed according to intravenous (IV) tissue plasminogen activator (tPA) treatment and favorable outcome. Among the 446 enrolled patients, 227 patients underwent IV tPA treatment and 216 had mRS score 0-2 at discharge. Patients with favorable outcomes had lower initial NIH Stroke Scale (NIHSS) scores, less frequent progressive neurological deficits, and lower systolic BP (SBP) 12 and 24 hours after admission than patients with unfavorable outcomes, regardless of whether they underwent tPA treatment or not (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0224293