TITLE

Presión arterial sistólica y pronóstico funcional en pacientes con enfermedad vascular cerebral aguda: Registro mexicano de enfermedad vascular cerebral

AUTHOR(S)

Baños-González, Manuel; Cantú-Brito, Carlos; Chiquete, Erwin; Arauz, Antonio; Ruiz-Sandoval, José Luís; Villarreal-Careaga, Jorge; Barinagarrementeria, Fernando; Lozano, José Juan

PUB. DATE

July 2011

SOURCE

Archivos de Cardiología de México;jul-sep2011, Vol. 81 Issue 3, p169

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

Objective: To analyze the association between the admission systolic blood pressure (SBP) and 30-day outcome in patients with acute cerebrovascular disease. Methods: The REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) is a hospital-based multicenter registry performed between November 2002 and October 2004. A total of 2000 patients with clinical syndromes of acute cerebrovascular disease confirmed by neuroimaging were registered. The modified Rankin scale was used for outcome stratification. Results: We analyzed 1721 patients who had registered their SBP: 78 (4.5%) had transient ischemic attack, 894 (51.9%) brain infarction, 534 (30.9%) intracerebral hemorrhage, 165 (9.6%) subarachnoid hemorrhage and 50 (2.9%) cerebral venous thrombosis. Among 1036 (60.2%) patients with the antecedent of hypertension, only 32.4% had regular treatment. The 30-day case fatality rate presented a J pattern with respect to SBP, so that the risk of death was highest in <100 mmHg (37.5%), decreased between 100 and 139, and reached gradually a new zenith in ≥220 mmHg (35.3%). The best functional outcome corresponded to patients who had SBP between 100 mmHg and 159 mmHg. In a Cox proportional hazards model, SBP <100 mmHg or ≥220 mmHg was an independent risk factor for 30-day mortality (RR: 1.52, IC 95%: 1.07 - 2.15), as well as the antecedent of hypertension (RR: 1.33, IC 95%: 1.06 - 1.65) and age >65 years (RR: 2.16, IC 95%: 1.74 - 2.67). Conclusion: Both hypotension and significant arterial hypertension at hospital admission are associated with an adverse outcome after acute cerebrovascular disease. Nevertheless, a good functional outcome can be attained in a wide range of SBP.

ACCESSION #

72673173

 

Related Articles

• Presión arterial sistólica y pronóstico funcional en pacientes con enfermedad vascular cerebral aguda: Registro mexicano de enfermedad vascular cerebral. Constante-Sotelo, José Luis // Archivos de Cardiología de México;jul-sep2011, Vol. 81 Issue 3, p176 

  No abstract available.

• Outcome after Stroke upon Awakening. Nadeau, Janel O.; Jiming Fang; Kapral, Moira K.; Silver, Frank L. // Canadian Journal of Neurological Sciences;May2005, Vol. 32 Issue 2, p232 

  Evaluates the outcomes among patients who woke up with stroke compared to those who were awake at stroke onset. Likelihood of patients with stroke-on-awakening to have higher blood pressure and to suffer ischemic stroke; Aim of the study to understand whether a population of patients exists who...

• Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. Coull, A J; Lovett, J K; Rothwell, P M // BMJ: British Medical Journal (International Edition);2/7/2004, Vol. 328 Issue 7435, p326 

  Abstract Objective: To estimate the very early stroke risk after a transient ischaemic attack (TIA) or minor stroke and thereby inform the planning of effective stroke prevention services. Design: Population based prospective cohort study of patients with TIA or stroke. Setting: Nine general...

• Unsolved Issues in the Management of High Blood Pressure in Acute Ischemic Stroke. Hubert, Gordian J.; Müller-Barna, Peter; Haberl, Roman L. // International Journal of Hypertension;2013, p1 

  High blood pressure is common in acute stroke patients. Very high as well as very low blood pressure is associated with poor outcome. Spontaneous fall of blood pressure within the first few days after stroke was associated both with neurological improvement and impairment. Several randomized...

• Headache as a Predictive Factor of Severe Systolic Hypertension in Acute Ischemic Stroke. Yoon-Ho Hong; Yong-Seok Lee; Seong-Ho Park // Canadian Journal of Neurological Sciences;Aug2003, Vol. 30 Issue 3, p210 

  Investigates the correlating factors associated with blood pressure elevation in acute ischemic stroke. Close association between headache and severe systolic blood pressure elevation in acute ischemic stroke; mean systolic and diastolic blood pressure compared between the different stroke...

• Glial cells. White, Adrian // Acupuncture in Medicine;Sep2011, Vol. 29 Issue 3, p238 

  The article presents a commentary on the article "Study on the Correlation Between Synaptic Reconstruction and Astrocyte After Ischemia and the Influence of Electroacupuncture on Rats" by Y. Luo, N. G. Xu and W. Yi.

• Tight blood pressure control prevents blindness in patients with diabetes.  // Journal of Family Practice;Feb2005, Vol. 54 Issue 2, p106 

  This article presents a summary of research on the clinical question of whether tight blood pressure control improves visual outcomes in diabetic hypertensive patients. A randomized control trial was used in an outpatient setting. The primary patient-oriented outcomes are blindness and reduction...

• Analysis of risk factors in patients treated by stroke in Clinical Hospital Mostar. Saric, Bajro; Buric, Selma; Vasilj, Ivan; Saric, Belma; Simovic, Mario // HealthMed;2011, Vol. 5 Issue 4, p936 

  Objective: To examine risk factors in patients diagnosed with stroke and the association of these factors with the diagnosis, complications and outcome. Subjects and methods: The study was structured as a study intersection. The sample includes 347 patients with stroke hospitalized in the period...

• Administering antihypertensive drugs after acute ischemic stroke: timing is everything. Semplicini, Andrea; Calò, Lorenzo // CMAJ: Canadian Medical Association Journal;3/1/2005, Vol. 172 Issue 5, p625 

  Discusses the administration of antihypertensive drugs for patients after acute ischemic stroke. Information on hypertension; Observation of studies on the relation between baseline blood pressure and likelihood of adverse clinical outcome; Impact of blood pressure changes on cerebral perfusion...

Read the Article