Nocturnal blood pressure dipping in acute ischemic stroke. (24th March 2015)

• Record Type: Journal Article
• Authors: Sargento‐Freitas, J.; Laranjinha, I.; Galego, O.; Rebelo‐Ferreira, A.; Moura, B.; Correia, M.; Silva, F.; Machado, C.; Cordeiro, G.; Cunha, L.
• Is Part Of: Acta neurologica Scandinavica. Volume 132:Number 5(2015:Nov.)
• Page Start: 323
• Page End: 328
• Publication Date: 2015-03-24
• Subjects: Neurology -- Periodicals; 616.8
• DOI: 10.1111/ane.12402
• Languages: English
• ISSNs: 0001-6314

Abstract

<abstract abstract-type="main" id="ane12402-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ane12402-sec-0001" sec-type="section"> <title>Objectives</title> <p>We aim to assess the impact of early nocturnal blood pressure (BP) variation in the functional outcome of patients after an acute ischemic stroke.</p> </sec> <sec id="ane12402-sec-0002" sec-type="section"> <title>Materials and methods</title> <p>We included consecutive stroke patients treated with intravenous thrombolysis (IVrtPA) in a tertiary stroke center. BP measurements were performed at regular intervals throughout day and night during the first 48 h after stroke onset, and subjects were divided into four dipping categories (extreme dippers, dippers, non‐dippers, and reverse dippers). Recanalization was assessed by transcranial color‐coded Doppler and/or angiographic CT. Hemorrhagic transformation was evaluated at 24 h follow‐up CT scan. Functional outcome was evaluated at 3 months after stroke using the modified Rankin Scale.</p> </sec> <sec id="ane12402-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 304 patients were included, mean age 72.80 ± 11.10 years. After 24 h of systolic BP monitoring, 30.59% were classified as reverse dippers, 39.14% as non‐dippers, 19.10% as dippers, and 11.18% as extreme dippers. Multivariate analysis did not show an independent association of any dipping class with 3‐month functional outcome. Hemorrhagic transformation was not uniform between dipping classes: 25.81% for reverse dippers, 14.29% for non‐dippers, 15.52% for dippers, and 5.88% for extreme dippers, <italic>P</italic> = 0.033.</p> </sec> <sec id="ane12402-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Nocturnal BP dipping pattern is not associated with functional outcome at 3 months in acute stroke patients treated with IVrtPA. Hemorrhagic transformation was more frequent in reverse dippers.</p> </sec> </abstract>