A Fall in Systolic Blood Pressure 24 Hours after Thrombolysis for Acute Ischemic Stroke Is Associated with Early Neurological Recovery

Background Outcomes are worse in patients who underwent thrombolysis for acute ischemic stroke (AIS) with persistent hypertension. The objective of this study is to investigate whether fall in systolic blood pressure (SBP) has any relationship with neurological outcome 24 hours after thrombolysis, a...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2016-06, Vol.25 (6), p.1539-1543
Main Authors: Gill, Dipender, MA (Oxon), BM BCh, MRCP (UK), Cox, Thomas, MA (Cantab), MB BS, Aravind, Adarsh, MB BS, MRCP (UK), Wilding, Peter, BSc, Korompoki, Eleni, MD, PhD, Veltkamp, Roland, MD, FESO, Kar, Arindam, MA (Oxon), BM BCh, MRCP (UK)
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Blood Pressure
Brain Ischemia - diagnosis
Brain Ischemia - drug therapy
Brain Ischemia - physiopathology
Cardiovascular
cerebral infarction
Databases, Factual
Disability Evaluation
Female
Fibrinolytic Agents - administration & dosage
Fibrinolytic Agents - adverse effects
Humans
hypertension
Hypertension - diagnosis
Hypertension - physiopathology
Infusions, Intravenous
ischemic stroke
London
Male
Middle Aged
Multivariate Analysis
Neurology
Recovery of Function
Retrospective Studies
Risk Factors
rtPA
Stroke - diagnosis
Stroke - drug therapy
Stroke - physiopathology
Systole
thrombolysis
Thrombolytic Therapy - adverse effects
Time Factors
Tissue Plasminogen Activator - administration & dosage
Tissue Plasminogen Activator - adverse effects
tPA
Treatment Outcome
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Summary:Background Outcomes are worse in patients who underwent thrombolysis for acute ischemic stroke (AIS) with persistent hypertension. The objective of this study is to investigate whether fall in systolic blood pressure (SBP) has any relationship with neurological outcome 24 hours after thrombolysis, after adjusting for potentially confounding factors. Methods Retrospective analysis of a single-center database of consecutive thrombolysis cases for AIS. Multivariate regression analysis was used to explore the relationship between fall in SBP and reduction in National Institutes of Health Stroke Scale (NIHSS) score 24 hours after thrombolysis. Other potentially confounding predictor variables used in the model were SBP on thrombolysis, blood glucose level on thrombolysis, NIHSS score on thrombolysis, administration of antihypertensive medications, and the time to thrombolysis after symptom onset. Results A fall in SBP 24 hours after thrombolysis is independently associated with greater improvement in NIHSS score 24 hours after thrombolysis (coefficient .051, 95% confidence interval .023-.078, P  
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2016.03.002