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Association between antihypertensive treatment, blood pressure variability, and stroke severity and outcomes in acute

Anastasia Karagiannaki1, Nikolaos Kakaletsis2, Ioanna Chouvarda3

  • 1Department of Internal Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|May 16, 2024
PubMed

Insights

Antihypertensive medication use in acute ischemic stroke (AIS) patients impacts blood pressure variability and is linked to reduced mortality. Personalized management based on prior medication history may improve outcomes for AIS patients.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Blood pressure management in acute ischemic stroke (AIS) is complex.
  • The role of antihypertensive medications (AHT) before and during stroke is not fully understood.

Purpose of the Study:

  • To investigate the impact of pre- and intra-stroke AHT use on blood pressure (BP) parameters and variability.
  • To assess the association between AHT use and 3-month mortality in AIS patients.

Main Methods:

  • Post-hoc analysis of 228 AIS patients from the PREVISE study.
  • 24-hour ambulatory BP monitoring within 48 hours of symptom onset.
  • Analysis of clinical data, AHT details, and 3-month mortality.

Main Results:

  • Most AIS patients (84.2%) were on AHTs prior to stroke.
  • Specific AHTs were associated with altered BP variability and daytime BP levels.
  • AHT use during AIS was linked to reduced mortality, with certain AHT classes showing better outcomes.

Conclusions:

  • Personalized BP management in AIS, considering antihypertensive history, is recommended.
  • These findings can guide treatment efficacy, future research, and patient care in AIS.
Abstract

Keywords:
Acute ischemic strokeAmbulatory blood pressure monitoringAntihypertensiveBlood pressure variability

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