Zaporožskij Medicinskij Žurnal (Dec 2016)
Ambulatory blood pressure monitoring in essential hypertensive patients with acute ischaemic stroke
Abstract
Blood pressure (BP) has been identified as a risk factor for various health disorders, including stroke onsets. Hypertension is one of the crucial health problem among adult Ukrainian. Due to the importance of elevated BP in stroke causality, BP measurement remains critical. However, it is limited information about value in clinical practice of ambulatory blood pressure monitoring (ABPM) data in hypertensive patients with inadequately controlled BP with acute stroke compared with those individuals who has no vascular onset. The aim of the study was to determine ABPM parameters in essential hypertensive patients with ischaemic hemisphere stroke. Materials and methods. A total of 114 study participants were analyzed (mean age 62 (56;72) years, 40 % women). We divided them into two groups according to the level of 24-h systolic BP (SBP) and diastolic BP (DBP), and the results of clinical examination. The first group (n=83) were inadequately controlled essential hypertensive individuals with high systolic or/and diastolic BP level according to the ABMP results, and the second one (n=31) were EH patients with an acute hemispheric ischaemic stroke (IS). Diagnosis of stroke was confirmed with clinical examination and computed tomography scan or magnetic resonance imaging results, and ABPM was conducted in 4.2±2.3 days after the stroke onset. Results. We had statistician difference (p<0.001) between groups of such parameters, as average SBP (diurnal, daytime, nighttime); diurnal pulse BP; SBP load (p<0.05); the diurnal AASI (p<0.05); circadian rhythm of DBP (p<0.05). No differences were found between the groups in morning surge calculated as speed and amplitude of the BP climbed in morning hours both for SBP (P=0.422 and P=0.395, respectively) and DBP (P=0.860 and P=0.337, respectively). Conclusion. In the present study, we evaluated the ABPM parameters in inadequately controlled essential hypertensive individuals with and without acute ischaemic hemispheric stroke. There was no statistical difference in ABPM parameters as for diastolic BP (averages, BP load) and for systolic BP (some parameters of BP load, variability). Meanwhile, there was statistician difference in systolic BP profile (averages, BP load, and the circadian index), pulse BP and the diurnal AASI.
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