24 hour ambulatory blood pressure monitoring during and following stroke

Abstract

Some three-quarters of patients with ischemic stroke have been observed to exhibit elevated blood pressure during the first 24–48 hours of onset, most likely as a physiological response to brain ischemia. In light of the dearth of 24-hour blood pressure monitoring studies during and following such events, we undertook such a study. Fourteen conscious stroke patients underwent 24 hour ambulatory BP monitoring using the Suntech Accutracker Dx (Suntech Medical Instruments, Raleigh NC, USA) on day 1–2 (period 1) and day 5–6 (period 2) of hospital admission. Data were analyzed by paired T-test and non-parametric sign rank test for assessing differences between baseline and post-baseline measurements for quantitative parameters. All tests were two-tailed, and p value of ≤ 5% was considered statistically significant. The data was analyzed using the SAS software (SAS Institute, Cary, NC, USA). Blood pressure spontaneously fell more than 15 mmHg systolic and 10 mmHg diastolic a few days following the acute event without significantly changing antihypertensive therapy.While reducing high blood pressure can prevent first and recurrent stroke, aggressive lowering of blood pressure during the acute stage may lead to harmful cerebral hypoperfusion. Caution is recommended in view of the natural tendency of blood pressure to begin falling a few days after stroke onset and to subsequently level off. (See Table) Results of 24 hour blood pressure monitoring Results of 24 hour blood pressure monitoring