[Morning blood pressure surge in patients with recent ischaemic stroke: the neglected factor]

Area of Science:

• Cardiology
• Neurology
• Hypertension Research

Background:

• High morning blood pressure surge (MBPS) is a known risk factor for cardiovascular events.
• The prevalence and significance of high MBPS in patients with recent ischemic stroke were previously unclear.

Purpose of the Study:

• To evaluate the presence of high MBPS in patients who have experienced a recent ischemic stroke.
• To compare MBPS in stroke patients with a control group of hypertensive individuals without cardiovascular disease.

Main Methods:

• A case-control study involving 100 patients with recent ischemic stroke and 50 hypertensive controls without cardiovascular disease.
• Analysis included assessment of MBPS, office BP, 24-hour BP, and daytime BP.
• Multivariate analysis was used to identify factors associated with elevated MBPS in stroke patients.

Main Results:

• High MBPS was observed in 9% of stroke patients and 8% of controls, with no significant difference between groups.
• Mean MBPS values were similar between stroke patients and controls (23.9±14 mmHg vs. 24.9±15 mmHg).
• In stroke patients, high MBPS was associated with prior coronary heart disease and a non-dipping circadian BP pattern, but not antihypertensive treatment. Multivariate analysis confirmed association only with prior coronary artery disease.

Conclusions:

• About 10% of patients with recent ischemic stroke have a high MBPS.
• The study underscores the need for specific strategies to identify and treat high MBPS in the post-stroke population.
• High MBPS in stroke patients is linked to underlying coronary artery disease.