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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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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

Summary

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.

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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.