Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration

Sare, Gillian M. and Ali, Myzoon and Shuaib, Ashfaq and Bath, Philip M.W. (2009) Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration. Stroke, 40 (6). pp. 2098-2103. ISSN 0039-2499

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Abstract

Background and Purpose—High blood pressure (BP) is associated independently with poor outcome after acute ischemic stroke, although in most analyses “baseline” BP was measured 24 hours or more postictus, and not during the hyperacute period.

Methods—Analyses included 1722 patients in hyperacute trials (recruitment 8 hours) from the Virtual Stroke

International Stroke Trial Archive (VISTA) Collaboration. Data on BP at enrolment and after 1, 2, 16, 24, 48, and 72

hours, neurological impairment at 7 days (NIHSS), and functional outcome at 90 days (modified Rankin scale) were

assessed using logistic regression models, adjusted for confounding variables; results are for 10-mm Hg change in BP. Results—Mean time to enrolment was 3.7 hours (range 1.0 to 7.9). High systolic BP (SBP) was significantly associated

with increased neurological impairment (odds ratio, OR 1.06, 95% confidence interval, 95% CI 1.01 to 1.12), and poor functional outcome; odds ratios for both increased with later BP measurements made at up to 24 hours poststroke. Smaller (versus larger) declines in SBP over the first 24 hours were significantly associated with poor NIHSS scores (OR 1.16, 95% CI 1.05 to 1.27) and functional outcome (OR 1.23, 95% CI 1.13 to 1.34). A large variability in SBP was also associated with poor functional outcome.

Conclusions—High SBP and large variability in SBP in the hyperacute stages of ischemic stroke are associated with

increased neurological impairment and poor functional outcome, as are small falls in SBP over the first 24 hours.

Item Type: Article
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Clinical Neuroscience
Depositing User: Sayers, Hazel
Date Deposited: 17 Jun 2010 11:24
Last Modified: 14 Aug 2013 12:49
URI: http://eprints.nottingham.ac.uk/id/eprint/1081

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