Key result
Acute ischaemic stroke is linked to ~13 mm Hg higher 24-hour SBP in hypertensive patients.
Why the study?
There is limited information about the clinical value of ambulatory blood pressure monitoring data in hypertensive patients with inadequately controlled BP and acute ischaemic stroke compared to those without vascular onset.
How do ambulatory blood pressure monitoring parameters differ between essential hypertensive patients with and without acute ischaemic stroke?
Cross-Sectional (n=114)
No
How do ambulatory blood pressure monitoring parameters differ between essential hypertensive patients with and without acute ischaemic stroke?
Essential hypertensive patients with acute ischaemic stroke exhibit significantly different ambulatory blood pressure profiles, particularly in systolic BP averages, pulse BP, and diurnal AASI, compared to those without stroke.
Answers are grounded in this paper and cite their sources.
ABPM data may refine risk assessment in acute stroke with uncontrolled hypertension; hypothesis-generating and requires prospective validation before practice change.
Blood pressure (BP) has been identified as a risk factor for various health disorders, including stroke onsets. Hypertension is one of the crucial health problem among adult Ukrainian. Due to the importance of elevated BP in stroke causality, BP measurement remains critical. However, it is limited information about value in clinical practice of ambulatory blood pressure monitoring (ABPM) data in hypertensive patients with inadequately controlled BP with acute stroke compared with those individuals who has no vascular onset.The aim of the study was to determine ABPM parameters in essential hypertensive patients with ischaemic hemisphere stroke.Materials and methods. A total of 114 study participants were analyzed (mean age 62 (56;72) years, 40 % women). We divided them into two groups according to the level of 24-h systolic BP (SBP) and diastolic BP (DBP), and the results of clinical examination. The first group (n=83) were inadequately controlled essential hypertensive individuals with high systolic or/and diastolic BP level according to the ABMP results, and the second one (n=31) were EH patients with an acute hemispheric ischaemic stroke (IS). Diagnosis of stroke was confirmed with clinical examination and computed tomography scan or magnetic resonance imaging results, and ABPM was conducted in 4.2±2.3 days after the stroke onset.Results. We had statistician difference (p<0.001) between groups of such parameters, as average SBP (diurnal, daytime, nighttime); diurnal pulse BP; SBP load (p<0.05); the diurnal AASI (p<0.05); circadian rhythm of DBP (p<0.05). No differences were found between the groups in morning surge calculated as speed and amplitude of the BP climbed in morning hours both for SBP (P=0.422 and P=0.395, respectively) and DBP (P=0.860 and P=0.337, respectively).Conclusion. In the present study, we evaluated the ABPM parameters in inadequately controlled essential hypertensive individuals with and without acute ischaemic hemispheric stroke. There was no statistical difference in ABPM parameters as for diastolic BP (averages, BP load) and for systolic BP (some parameters of BP load, variability). Meanwhile, there was statistician difference in systolic BP profile (averages, BP load, and the circadian index), pulse BP and the diurnal AASI.
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S. P. Zhemanyuk (2016) conducted a cross-sectional in Essential hypertension with acute ischaemic stroke (n=114). Acute hemispheric ischaemic stroke vs. Inadequately controlled essential hypertension without acute stroke was evaluated on 24-hour average systolic blood pressure (SBP24) (p=<0.001). Acute ischaemic stroke in patients with essential hypertension was associated with higher 24-hour average systolic blood pressure compared to those without stroke.
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