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Long-term lowering of blood pressure after carotid and vertebrobasilar ischemic stroke
M Guidotti1, A Ciccone, P Garavaglia
1Divisione di Neurologia, Ospedale, Valduce, Como, Italy.
Insights
Essential hypertension patients experiencing ischemic stroke showed significant post-stroke blood pressure normalization, particularly after carotid strokes. This finding may inform future research on hypertension development.
Area of Science:
- Neurology
- Cardiology
- Hypertension Research
Background:
- Essential hypertension is a significant risk factor for ischemic stroke.
- Post-stroke changes in blood pressure are a recognized but not fully understood phenomenon.
- Understanding blood pressure dynamics after stroke is crucial for patient management.
Purpose of the Study:
- To analyze the phenomenon of post-stroke blood pressure lowering in patients with essential hypertension.
- To identify factors associated with blood pressure normalization after ischemic stroke.
- To explore potential differences in blood pressure changes based on stroke location.
Main Methods:
- A prospective follow-up study of 107 patients with a first-ever ischemic stroke and pre-existing essential hypertension (≥1 year).
- Assessment of arterial blood pressure at three months post-stroke.
- Comparison of normotensive and hypertensive patients regarding cerebrovascular risk factors and disability.
- Analysis of blood pressure normalization rates based on stroke location (carotid vs. vertebrobasilar).
Main Results:
- Of 82 surviving patients at three months, 44 (54%) exhibited normal arterial blood pressure.
- No significant differences in cerebrovascular risk factors or disability were found between normotensive and hypertensive groups.
- Blood pressure normalized in 63% of carotid stroke patients versus 36% of vertebrobasilar stroke patients (p = 0.035).
Conclusions:
- A substantial proportion of patients with essential hypertension experience blood pressure normalization after an ischemic stroke.
- Stroke location appears to influence the likelihood of post-stroke blood pressure normalization.
- These findings suggest a potential link between stroke and hypertension regulation, warranting further investigation into the neurogenesis of arterial hypertension.
Abstract:
We followed up 107 patients experiencing a first-ever ischemic stroke after having been affected by essential hypertension for at least one year, in order to analyze the phenomenon of post-stroke blood pressure lowering. Of the 82 patients still surviving after three months of follow-up, 44 (54%) had normal arterial blood pressure values. There were no significant differences between these normotensive patients and the 38 with high blood pressure in terms of cerebrovascular risk factors or disability, but blood pressure normalized in 34 of the 54 patients experiencing a carotid stroke (63%) and in only 10 of the 28 experiencing vertebrobasilar stroke (36%) (p = 0.035). These data may offer a starting point for further studies of the neurogenesis of arterial hypertension.