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[Arterial pressure variability in the acute phase of a cerebral stroke]
1Istituto di Clinica Medica II, Università degli Studi di Pisa.
Objective:
Acute stroke may cause hypertension and recently available devices for noninvasive blood pressure monitoring make it possible to study short-term variability of pressure in this condition.
Design And Methods:
Eight patients (5 males, 3 females, mean age 66 +/- 12 years) with haemorrhagic stroke and 13 male patients (mean age 73 +/- 10 years) with thrombo-embolic stroke underwent 24-hour blood pressure monitoring in the acute stage by the Takeda Medical 2420 (A&D Co., Japan), programmed to measure blood pressure every 10 min during day-time and 15 min during night-time. Blood pressure variability was measured by the variability coefficient (standard deviation/24 h mean). The diagnosis was confirmed in all cases by Computed Tomography scanning. Statistical differences between groups were evaluated by Student's "t" test for independent samples.
Results:
In haemorrhagic stroke the mean of variability coefficient proved be 10.7% for systolic and 12.8% for diastolic blood pressure, whereas in thromboembolic stroke it was 14.1% for systolic and 17.7% for diastolic blood pressure. The difference between means was statistically significant (p < 0.02 for systolic and p < 0.01 for diastolic blood pressure).
Conclusions:
Blood pressure variability is greater in thrombo-embolic, than haemorrhagic stroke. The hypervariability can be misleading in judging the hypertensive state in this condition.