Blood pressures immediately following ischemic strokes are associated with cerebral perfusion and neurologic function

J Clin Hypertens (Greenwich). 2018 Jun;20(6):1008-1015. doi: 10.1111/jch.13310. Epub 2018 May 23.

Abstract

The optimal range of blood pressure levels in the early phase of ischemic stroke with hypertension is still controversial. Based on our stroke registry database, we explored the relationship between blood pressure levels and cerebral perfusion in the early phase of ischemic stroke with hypertension and neurofunctional recovery at 3 months after stroke. Total 732 stroke patients with hypertension were finally analyzed. Patients were divided into quintiles according to systolic blood pressure (SBP) and diastolic blood pressure (DBP) to perform multivariable logistic regression to analyze their relation with neurofunctional recovery, respectively. The cerebral perfusion levels displayed a reverse "U" shape curve with the change of blood pressure levels. Sufficient estimated cerebral blood flow (ECBF) in the early phase of ischemic stroke was associated with good neurofunctional recovery at 3 months after stroke. The best neurofunctional recovery was observed in the middle quintiles with SBP at 161 to 177 mm Hg and DBP at 103 to 114 mm Hg, respectively. So maintaining appropriate blood pressure levels in the early phase of ischemic stroke might be beneficial to cerebral perfusion and neurofunctional recovery.

Keywords: acute phase; hypertension; ischemic stroke; neurofunctional recovery; prognosis.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Pressure
  • Blood Pressure Determination
  • Brain Ischemia / physiopathology*
  • Cerebrovascular Circulation
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Recovery of Function
  • Registries
  • Regression Analysis
  • Risk Factors
  • Stroke / physiopathology*

Associated data

  • ChiCTR/ChiCTRTRC‐14004804