Blood pressure evolution in young patients with acute ischemic stroke: a new model for understanding the natural course of spontaneous hypertension?

Int J Neurosci. 2018 Feb;128(2):140-145. doi: 10.1080/00207454.2017.1378198. Epub 2017 Oct 10.

Abstract

Background: Approximately 80% of patients suffering an acute ischemic stroke develop transient hypertension. The physiopathological mechanism remains unclear. Due to the lack of vascular risk factors, young adults could be a useful model for understanding blood pressure (BP) evolution in this setting.

Methods: Patients between 18 and 55 years old admitted with an acute ischemic stroke were included. BP was evaluated during the following 48 h. Hypertension was defined as: systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. Patients were divided into two groups: RF group included those who had a previous vascular risk factor and/or other medical condition known to affect the autonomic function; noRF group included patients without any of the previously stated conditions.

Results: Thirty-nine patients were included: mean age: 44.26 years old, 21 were males (53.8%). Mean SBP and DBP at admission were 139.77 ± 5.35 mmHg (range: 90-243) and 84.44 ± 3.02 mmHg (range: 60-128), respectively; 43.58% patients were hypertensive at admission. SBP decreased significantly during the first 48 h (p = 0.044) for the entire population. RF group has higher SBP (p = 0.009) and DBP (p = 0.011) at admission than the noRF group.

Conclusion: Most patients were normotensive at admission and BP fell spontaneously despite BP at admission. Young patients without medical conditions that could alter the autonomic system function could be a useful model for understanding acute hypertension in ischemic stroke.

Keywords: Hypertension; acute stroke; blood pressure; ischemic stroke; young patients.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Blood Pressure / physiology*
  • Brain Ischemia / physiopathology*
  • Disease Progression
  • Female
  • Humans
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Models, Theoretical
  • Risk Factors
  • Stroke / physiopathology*
  • Young Adult