The impact of blood pressure hemodynamics in acute ischemic stroke: A prospective cohort study

Latha Ganti Stead, Sailaja Enduri, Fernanda Bellolio, Anunaya R. Jain, Lekshmi Vaidyanathan, Rachel M. Gilmore, Rahul Kashyap, Amy L. Weaver, Robert D Jr. Brown

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3 Citations (Scopus)

Abstract

Objective: To assess relationships between blood pressure hemodynamic measures and outcomes after acute ischemic stroke, including stroke severity, disability and death. Methods: The study cohort consisted of 189 patients who presented to our emergency department with ischemic stroke of less than 24 hours onset who had hemodynamic parameters recorded and available for review. Blood pressure (BP) was non-invasively measured at 5 minute intervals for the length of the patient's emergency department stay. Systolic BP (sBP) and diastolic BP (dBP) were measured for each patient and a differential (the maximum minus the minimum BP) calculated. Three outcomes were studied: stroke severity, disability at hospital discharge, and death at 90 days. Statistical tests used included Spearman correlations (for stroke severity), Wilcoxon test (for disability) and Cox models (for death). Results: Larger differentials of either dBP (p = 0.003) or sBP (p < 0.001) were significantly associated with more severe strokes. A greater dBP (p = 0.019) or sBP (p = 0.036) differential was associated with a significantly worse functional outcome at hospital discharge. Those patients with larger differentials of either dBP (p = 0.008) or sBP (0.007) were also significantly more likely to be dead at 90 days, independently of the basal BP. Conclusion: A large differential in either systolic or diastolic blood pressure within 24 hours of symptom onset in acute ischemic stroke appears to be associated with more severe strokes, worse functional outcome and early death

Original languageEnglish (US)
Article number3
JournalInternational Journal of Emergency Medicine
Volume5
Issue number1
DOIs
StatePublished - 2012

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Cohort Studies
Hemodynamics
Stroke
Prospective Studies
Blood Pressure
Hospital Emergency Service
Proportional Hazards Models
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Emergency Medicine

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The impact of blood pressure hemodynamics in acute ischemic stroke : A prospective cohort study. / Stead, Latha Ganti; Enduri, Sailaja; Bellolio, Fernanda; Jain, Anunaya R.; Vaidyanathan, Lekshmi; Gilmore, Rachel M.; Kashyap, Rahul; Weaver, Amy L.; Brown, Robert D Jr.

In: International Journal of Emergency Medicine, Vol. 5, No. 1, 3, 2012.

Research output: Contribution to journalArticle

Stead, Latha Ganti ; Enduri, Sailaja ; Bellolio, Fernanda ; Jain, Anunaya R. ; Vaidyanathan, Lekshmi ; Gilmore, Rachel M. ; Kashyap, Rahul ; Weaver, Amy L. ; Brown, Robert D Jr. / The impact of blood pressure hemodynamics in acute ischemic stroke : A prospective cohort study. In: International Journal of Emergency Medicine. 2012 ; Vol. 5, No. 1.
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