Recovery Dynamics in Patients with Ischemic Stroke Depending on the Blood Pressure Indicators and Its Variability

Abstract

The study aims to neurological and functional recovery in patients after ischemic stroke depending on blood pressure (BP) parameters and its variability.Materials and methods: We examined 150 patients with ischemic stroke and arterial hypertension (AH) who were hospitalized in the neurological department (76 (50,7 %) men and 74 (49,3 %) women, mean age 67,4±7,3 years). All patients underwent standard physical and laboratory examinations, measurement of blood pressure in dynamics; The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological deficits at the time of admission to the hospital, in the dynamics of the acute period (up to 21 days) and on the 21st day.Results: It was found that the consequences of the acute period of stroke depend on the level of blood pressure and its variability at the beginning of the ac ute period. A more than 50 percent probability of a decrease in the NIHSS score by half (from baseline) is predicted if the patient has a standard deviation (SD) systolic blood pressure (SBP) less than 12,4 mm Hg on days 1–3. In addition, SD SBP on days 1–3 and 1–6 days, and SD diastolic blood pressure (DBP) from 1 to 3 days are the most significant in assessing the relationship with the degree of functional impairment at the end of the acute period of stroke.Conclusion: The level of blood pressure and its variability during the acute period of ischemic stroke makes it possible to predict the severity of the neurological deficit and the functional consequences of stroke in the recovery period (up to 21 days).

Keywords

• ischemic stroke
• arterial hypertension
• functional defect
• functional recovery
• blood pressure variability