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Blood pressure after stroke. A one-year follow-up study
1Karolinska Institute, Department of Medicine, Stockholm, Sweden.
Stroke
|February 1, 1993
Summary
Blood pressure often increases one month after acute stroke, remaining elevated for a year. Monitor blood pressure post-stroke, especially standing measurements, to guide antihypertensive treatment.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- Blood pressure fluctuations in the year following an acute stroke are not well-documented.
- Understanding post-stroke blood pressure trends is crucial for patient management.
Purpose of the Study:
- To investigate blood pressure changes in patients for one year after hospital discharge following an acute stroke.
- To identify factors influencing these blood pressure changes and their association with mortality.
Main Methods:
- Prospective study of 226 consecutive patients surviving acute stroke (mean age 73).
- Blood pressure was monitored for one year post-discharge.
- Analysis included demographic data, stroke diagnosis, hypertension history, and orthostatic hypotension.
Main Results:
- Two-thirds (69%) of patients experienced significant blood pressure increases one month post-discharge, which persisted throughout the year.
- Patients with a history of hypertension maintained significantly higher blood pressures.
- A decrease in blood pressure was observed in 31% of patients, associated with older age and higher mortality; 20% experienced orthostatic hypotension.
Conclusions:
- Antihypertensive medication should not be reduced prior to hospital discharge.
- Blood pressure assessment, including standing measurements, approximately one month after discharge is recommended for appropriate treatment decisions.
- Monitoring for orthostatic hypotension is important in post-stroke care.