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Predicting ischaemic stroke subtype from presenting systolic blood pressure: the BASIC Project

W J Meurer1, B N Sánchez, M A Smith

  • 1Stroke Program, University of Michigan Health System, USA.

Journal of Internal Medicine
|November 21, 2008
PubMed

Insights

Low systolic blood pressure (SBP) at presentation is linked to cardioembolic stroke, a type of ischemic stroke. Increased suspicion for this stroke subtype is warranted in patients with lower SBP.

Area of Science:

  • Neurology
  • Cardiology
  • Epidemiology

Background:

  • Ischemic stroke subtypes have varying etiologies and risk factors.
  • Understanding predictors of specific stroke subtypes is crucial for targeted prevention and treatment.
  • Systolic blood pressure (SBP) is a key cardiovascular risk factor, but its association with stroke etiology requires further elucidation.

Purpose of the Study:

  • To test the hypothesis that low presenting systolic blood pressure (SBP) predicts a cardioembolic stroke etiology.
  • To investigate the association between presenting SBP and ischemic stroke subtypes.

Main Methods:

  • A population-based study (Brain Attack Surveillance in Corpus Christi - BASIC) identified ischemic stroke cases.
  • Multinomial logistic regression analyzed the relationship between stroke subtype and initial SBP.
  • Data included 308 ischemic stroke cases with determined etiology between 2000-2002.

Main Results:

  • Lower presenting SBP was significantly associated with stroke subtype (P = 0.001).
  • Each 10 mmHg decrease in SBP increased the odds of cardioembolic stroke versus small vessel occlusion by 20%.
  • Older age was also associated with an increased odds of cardioembolic stroke.

Conclusions:

  • Lower initial SBP and older age are associated with cardioembolic stroke.
  • Clinicians should consider cardioembolic stroke in patients presenting with low SBP.
  • These findings aid in identifying stroke etiology and guiding clinical suspicion.
Abstract

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