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Relationship between mean blood pressure during hospitalization and clinical outcome after acute ischemic stroke

Manyan Hu1, Yuan Zhu1, Zhaoyao Chen1

  • 1Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China.

BMC Neurology
|April 20, 2023
PubMed

Insights

For acute ischemic stroke patients, maintaining blood pressure between 135-150 mmHg during hospitalization is crucial. Both higher and lower blood pressure levels are linked to worse outcomes.

Area of Science:

  • Neurology
  • Cardiology
  • Clinical Medicine

Background:

  • Optimal blood pressure (BP) management post-acute ischemic stroke (AIS) remains critical for patient recovery.
  • Understanding the precise BP targets is essential to improve clinical outcomes and reduce complications.

Purpose of the Study:

  • To investigate the relationship between mean blood pressure (BP) and clinical outcomes in patients hospitalized with acute ischemic stroke.
  • To determine the optimal BP range associated with better functional outcomes at 3 months post-AIS.

Main Methods:

  • A cohort of 649 acute ischemic stroke patients was analyzed.
  • Daily BP measurements were taken, and mean BP was calculated.
  • Clinical events and 3-month functional outcomes (modified Rankin Scale) were assessed using logistic regression analysis.

Main Results:

  • A nonlinear, U-shaped relationship was observed between systolic blood pressure (SBP) and poor clinical outcomes.
  • Patients with SBP < 135 mmHg or SBP > 150 mmHg had a significantly higher probability of adverse outcomes.
  • The optimal mean SBP range for better prognosis was identified as 135-150 mmHg.

Conclusions:

  • The study identifies an optimal SBP range of 135-150 mmHg for patients with acute ischemic stroke during hospitalization.
  • A U-shaped relationship exists between mean SBP and 3-month functional outcomes, indicating that both hypotension and hypertension are detrimental.
  • Clinical guidelines should consider this optimal BP range to improve prognosis in AIS patients.
Abstract

Keywords:
Acute ischemic strokeBlood pressureCerebral infarctionFunctional outcome

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