[PS 03-03] BLOOD PRESSURE DYNAMICS AND VARIABILITY IN PATIENTS WITH HYPERTENSIVE CRISIS AND ACUTE STROKE FROM BULGARIAN IN-HOSPITAL POPULATION

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Abstract

Objective:

Blood pressure variability (BPV) is considered an independent poor prognostic factor in acute stroke. The aim of the study was to analyze the blood pressure (BP) dynamics and variability in patients with hypertensive crisis and acute ischemic (IS) or hemorrhagic stroke (HS).

Design and method:

The study included 108 randomly selected in-hospital patients (equal men and women) with acute stroke /70 patients with IS and 38 with HS/, accompanied by hypertensive crisis at admission (systolic blood pressure /SBP/>180 mmHg and/or diastolic blood pressure /DBP/>120 mmHg). Dynamics of BP, some indices of BPV and their potential association with the outcome of stroke were analyzed.

Results:

Some differences in BP dynamics and BPV between the two types of stroke were found. Patients with HS demonstrated significantly higher initial levels of SBP, pulse pressure and mean BP. The BP drop was steeper in the first 24 hours and then smoother. We observed more gradual fall in SBP and DBP in persons with clinical improvement. Those who did not improve or deteriorated showed steep reduction of SBP in the first 24 hours, then more fluctuations and a trend for slight increase >160 mmHg after the 24th hour. Significantly greater BPV was established in patients with HS. Indices of BPV significantly associated with the outcome at hospital dissmission in patients with IS were the maximal variations of SBP and in patients with HS - mean standard deviation of SBP, and maximal variations of SBP >50 mmHg.

Conclusions:

BP dynamics and BPV might be of definite importance for the outcome of acute stroke. In our study we observed significantly higher initial BP values and more variations in the group with HS, which correlated with worse prognosis. High BP in the acute phase of stroke should be reduced carefully using therapeutic strategies associated with stable BP and low BPV.

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