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Course of blood pressure after cerebral infarction and transient ischemic attack
P A Jansen1, B P Schulte, E F Poels
1Department of Medicine, Catholic University of Nijmegen, The Netherlands.
Insights
Blood pressure often rises during acute cerebral infarction or TIA but typically normalizes within days. However, elevated blood pressure can recur months after discharge, necessitating regular monitoring.
Area of Science:
- Neurology
- Cardiology
- Hypertension Research
Background:
- Cerebral infarction and transient ischemic attack (TIA) are significant neurological events.
- Blood pressure fluctuations are common in patients experiencing these events.
- Understanding post-event blood pressure trends is crucial for patient management.
Purpose of the Study:
- To investigate the blood pressure course in patients admitted for cerebral infarction or TIA.
- To analyze blood pressure changes from pre-event to acute post-event and long-term follow-up.
- To determine the prevalence of hypertension in the acute and recovery phases.
Main Methods:
- Retrospective analysis of pre-event blood pressure in 63 patients.
- Prospective monitoring of blood pressure post-admission.
- Follow-up blood pressure measurements at 2-6 months post-discharge without medication changes.
Main Results:
- 67% of patients exhibited elevated blood pressure on admission.
- Blood pressure decreased significantly within the first five days post-event.
- 29% of patients showed elevated blood pressure at 2-6 months follow-up.
Conclusions:
- Blood pressure is elevated in the acute phase of cerebral infarction and TIA.
- Spontaneous normalization of blood pressure occurs in most patients within the first week.
- Recurrent hypertension post-discharge highlights the need for sustained blood pressure monitoring.
Abstract:
In 63 patients, admitted for cerebral infarction or transient ischemic attack (TIA), the blood pressure course was studied. The blood pressure before the event was studied retrospectively; 32 patients were normotensive, in 31 patients existed hypertension, with antihypertensive treatment in 15 of these cases. The blood pressure after the event was studied prospectively, and turned out to be risen in 67% of the patients on the day of admission. It fell in the first day after infarction or TIA, mainly on the second day, to a plateau level reached on the fifth day. Only 3 patients (5%) remained hypertensive until discharge from the hospital. In 48 patients blood pressure values were available as measured two to six months after discharge, without a change in antihypertensive medication. Blood pressure was increased compared to the value measured before discharge. In 14 patients (29%) hypertensive blood pressure figures were measured at that time. It is concluded that blood pressure is elevated in the acute phase of cerebral infarction and TIA, but falls spontaneously in the first days to normotensive levels in most patients; because blood pressure may increase again, measurements of blood pressure within the first months after discharge are needed.