Influence of the Initial Readings of Blood Pressure Components on Functional Outcome in Acute Ischemic Stroke Patients

ABSTRACT

BACKGROUND: To investigate the influence of the initial readings of blood pressure (BP) components on functional outcome in acute ischemic stroke patients stratified by age. METHODS: We reviewed the medical records of 54 first-ever hemiplegic MCA ischemic stroke patients (age 61.6+/-9.6 years; 37men, 17 women). Subjects were stratified by age, and BP was measured six times within the initial 24 hours after stroke onset. The maximal systolic BP (MSBP), minimal diastolic BP (mDBP), and maximal pulse pressure (MPP) were selected for analysis. Functional outcomes were evaluated with the korean-modified Barthel index (K-MBI) and functional independence measure (FIM) at 3 months after stroke onset in all subjects. RESULTS: The amount of MSBP and MPP elevation was significantly higher in patients with diabetes mellitus and smoking history, respectively (p<0.05). In regards to age groups, MPP was inversely correlated with FIM (r= -0.727, p=0.027) in subjects in their 40s. Each of MSBP and MPP were inversely correlated with FIM in the 50s age group (r= -0.666, -0.761; p=0.013, 0.002). MPP was inversely correlated with each of K-MBI and FIM in the 60s age group (r= -0.659, -0.786; p=0.002, 0.000). MPP was inversely correlated with K-MBI, and MSBP was inversely correlated with FIM in the 70s age group (r= -0.787, -0.651; p=0.002, 0.022). CONCLUSION: In elderly patients with ischemic stroke, MPP was significantly correlated with functional outcome. Therefore, the tight control and management of pulse pressure from the acute stage of stroke should be seriously considered.