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High diastolic blood pressure is a risk factor for in-hospital mortality in complete MCA stroke patients

Valeria Caso1, Giancarlo Agnelli, Andrea Alberti

  • 1Stroke Unit and Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Sant'Andrea delle Fratte, 06126, Perugia, Italy. vcaso@hotmail.com

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|September 28, 2011
PubMed

Insights

High diastolic blood pressure on admission is a key predictor of in-hospital death in patients with complete middle cerebral artery (MCA) stroke. This finding highlights the importance of monitoring blood pressure in acute MCA stroke cases.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Critical Care Medicine

Background:

  • Complete middle cerebral artery (MCA) stroke presents a severe threat, potentially leading to malignant MCA syndrome, characterized by significant brain edema and herniation.
  • Patients experiencing complete MCA infarcts face high mortality rates due to associated complications.

Purpose of the Study:

  • To identify clinical predictors of in-hospital mortality in patients diagnosed with complete MCA stroke.
  • To investigate the association between admission diastolic blood pressure and mortality risk in this patient cohort.

Main Methods:

  • A prospective, single-center study enrolled consecutive patients with complete MCA stroke, with in-hospital mortality as the primary endpoint.
  • Clinical data, including National Institutes of Health Stroke Scale (NIHSS) scores and admission blood pressure, were collected and analyzed.

Main Results:

  • Out of 780 ischemic stroke patients, 125 (16%) had complete MCA strokes, with 44 (35.2%) succumbing to in-hospital mortality.
  • Both high NIHSS score (OR 1.17) and high diastolic blood pressure on admission (OR 1.05) were identified as independent predictors of in-hospital mortality.
  • A linear correlation was observed between elevated diastolic blood pressure and increased mortality risk; the risk of death rose by 5% for every 1 mmHg increase in diastolic blood pressure.

Conclusions:

  • Elevated diastolic blood pressure upon admission is a significant and independent predictor of in-hospital mortality in patients with acute complete MCA stroke.
  • These findings underscore the critical role of diastolic blood pressure management in improving outcomes for patients with severe MCA strokes.

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