Achieved blood pressure level and target organ damage in post-stroke hypertensive patients

Abstract

Objective. To assess the impact of the achieved blood pressure level on the structure and function of kidneys, carotid arteries and depression level in hypertensive post-stroke survivors.Design and methods.Carotid arteries and kidneys were assessed by ultrasound study. All parameters including depression level (Hamilton scale) were evaluated depending on the achieved systolic blood pressure level (SBP) in 88 hypertensive patients in acute post-stroke period and at follow-up (8–12 months after stroke). Multiple regression analysis was applied to assess the associations between the factors.Results.Office SBP directly correlates with the creatinine level (r = 0,5; р = 0,01). Moderate direct correlation was found between mean office SBP at the follow-up visit and intima-media thickness (IMT) (r = 0,47; р = 0,004), resistance index of the right common carotid artery (CCA) (r = 0,47; р = 0,006), resistance index of the left CCA (r = 0,5; р = 0,002), and resistance index of the left internal carotid artery (ICA) (r = 0,4; р = 0,02). Regression analysis demonstrated that mean office SBP has an impact on the following parameters: plasma creatinine level (β = 0,43; р = 0,04) and CCA IMT (β = 0,36; р = 0,03). The depression decreased in subjects with SBP 125–134 mmHg.Conclusion. SBP stabilization at the level 125–134 mmHg leads to the decrease in the resistance index of the carotid arteries, improves renal function and reduces depression level in post-stroke survivors.