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Factors influencing acute blood pressure values in stroke subtypes

Journal of Human Hypertension volume 18, pages 253–259 (2004)Cite this article

Abstract

The aim of this prospective observational study was to determine the association of acute blood pressure values with independent factors (demographic, clinical characteristics, early complications) in stroke subgroups of different aetiology. We evaluated data of 346 first-ever acute (<24 h) stroke patients treated in our stroke unit. Casual and 24-h blood pressure (BP) values were measured. Stroke risk factors and stroke severity on admission were documented. Strokes were divided into subgroups of different aetiopathogenic mechanism. Patients were imaged with CT-scan on admission and 5 days later to determine the presence of brain oedema and haemorrhagic transformation. The relationship of different factors to 24-h BP values (24-h BP) was evaluated separately in each stroke subgroup. In large artery atherosclerotic stroke (n=59), history of hypertension and stroke severity correlated with higher 24-h BP respectively. In cardioembolic stroke (n=87), history of hypertension, stroke severity, haemorrhagic transformation and brain oedema were associated with higher 24-h BP, while heart failure with lower 24-h BP. History of hypertension and coronary artery disease was related to higher and lower 24-h BP, respectively, in lacunar stroke (n=75). In patients with infarct of undetermined (n=57) cause 24-h BP were mainly influenced by stroke severity and history of hypertension. An independent association between higher 24-h BP and history of hypertension and cerebral oedema was documented in intracerebral haemorrhage (n=68). In conclusion, different factors influence acute BP values in stroke subtypes of different aetiology. If the clinical significance of these observations is verified, a differentiated approach in acute BP management based on stroke aetiology may be considered.

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Acknowledgements

We thank Miss Mary Batsara, Mrs Athina Peppa and Miss Angela Konstantinopoulou for their valuable help in data collection.

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Authors and Affiliations

  1. Department of Clinical Therapeutics, ‘Alexandra’ Hospital, University of Athens, Athens, Greece

    K N Vemmos, N Zakopoulos, E Manios & V Kotsis

  2. Department of Neurology, ‘Eginition’ Hospital, University of Athens, Athens, Greece

    K Spengos, G Tsivgoulis & D Vassilopoulos

  3. Department of Neurology, University of Heidelberg, Klinikum Mannheim, Mannheim, Germany

    M Daffertshofer

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  1. K N Vemmos
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  2. K Spengos
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  3. G Tsivgoulis
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  4. N Zakopoulos
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  5. E Manios
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Correspondence to K N Vemmos.

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Vemmos, K., Spengos, K., Tsivgoulis, G. et al. Factors influencing acute blood pressure values in stroke subtypes. J Hum Hypertens 18, 253–259 (2004). https://doi.org/10.1038/sj.jhh.1001662

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