Background
Intracranial atherosclerotic stenosis is common in Asian, black, and Hispanic individuals.
However, the management of blood pressure (BP) in the setting of acute stage in these
patients is controversial. The present study aims to explore the relationship between
BP on admission and outcomes in acute ischemic stroke patients with intracranial atherosclerotic
stenosis or occlusion.
Methods
We prospectively registered consecutive cases of acute ischemic stroke from September
01, 2009, to August 31, 2011. Patients with severe intracranial stenosis or occlusion
were included. Death or disability was followed up at the end of the third month.
The multivariate logistic regression model was used to analyze the relationship between
BP on admission and clinical outcomes.
Results
We included 215 cases, which accounted for 22.7% (215 of 946) of the total registered
cases. The mean age was 60.44 ± 13.23 years. The median time of symptoms onset to
admission was 72 hours (2-270 hours). Patients with systolic blood pressure (SBP)
of 120-159 mm Hg or diastolic BP of 70-89 mm Hg had the lowest death or disability.
After adjustment of confounders, SBP of 160 mm Hg or more on admission was the independent
predictor of death or disability at the third month (relative risk [RR], 2.89; 95%
confidence interval [CI], 1.20-6.91). SBP less than 120 mm Hg on admission had a trend
of increasing death or disability (RR, 1.96; 95% CI, .60-6.33).
Conclusions
Higher BP on admission was associated with an increased risk of death or disability
in patients with symptomatic intracranial artery stenosis or occlusion. It is reasonable
that further studies on the effects of BP lowering in acute stroke include these patients.
Key Words
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Article info
Publication history
Published online: March 31, 2014
Accepted:
November 27,
2013
Received in revised form:
November 18,
2013
Received:
October 16,
2013
Footnotes
This research was supported by the Science and Technology Infrastructure Projects of Sichuan Province (No. 2012JCPT008) and the Science and Technology Program of Science and Technology Department of Sichuan Province (No. 2011SZ0202).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.025
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
