Abstract P077: Hypertension And Ischemic Stroke; The Effect Of A Combined Anti-hypertension Medications And Thrombolytic Therapy

Abstract

Background: The aim of this study is to identify clinical risk factors in acute ischemic stroke ( AIS) pretreated with anti-hypertensive (anti-HTN) medications with a subsequent thrombolytic therapy that are associated with potential worsening or improving neurological functions. Methods: We analyzed retrospectively collected data from consecutive AIS patients with a combined anti-HTN medications and recombinant tissue plasminogen activator (rtPA) therapy for AIS. We used logistic regression model to identify demographic and clinical risk factors that are associated with improving or worsening neurologic functions in AIS patients with a combined anti-HTN and thrombolytic therapy. The overall correct classification of the logistic regression models was determined using the Hosmer-Lemeshow test, while the area under the receiver operating characteristic curve was used to test the sensitivity of the model. The variance inflation factor was used to check for multicollinearity. Results: In the adjusted analysis, patients with increasing age (Odd ratio (OR)=1.035, 95% CI, 1.022-1.049, P <0.001), female AIS patients (OR = 1.630, 95% CI, 1.182-2.248, P =0.002) with a history of substance abuse (OR = 2.315, 95% CI, 1.107-4.842, P = 0.026) were associated with worsening neurologic functions. However, Caucasians (OR = 0.535, 95% CI, 0.361-0.793, P = 0.002) with dyslipidemia (OR = 0.655, 95% CI, 0.479-0.897, P = 0.008), obesity (OR = 0.642, 95% CI, 0.472-0.873, P = 0.005), high-density lipoproteins (HDL; OR = 0.988, 95% CI, 0.976-1.000, P = 0.045), and with a direct admission (OR = 0.509, 95% CI, 0.341-0.761, P = 0.001) were associated with improving neurologic function in AIS patients with a combined anti-HTN medications and rtPA therapy. Conclusion: Our findings reveal specific demographic and clinical risk factors that are associated with worsening or improving neurological functions in AIS pretreated anti-HTN medications with a subsequent thrombolytic therapy. This finding suggests the development of management strategies to manage identified clinical risk factors in AIS patients pretreated with anti-HTN medications prior to thrombolytic therapy.