Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration
Background and Purpose—High blood pressure (BP) is associated independently with poor outcome after acute ischemic stroke, although in most analyses “baseline” BP was measured 24 hours or more postictus, and not during the hyperacute period. Methods—Analyses included 1722 patients in hyperacute tri...
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| Format: | Article |
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American Heart Association
2009
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| Online Access: | https://eprints.nottingham.ac.uk/1081/ |
| _version_ | 1848790536104706048 |
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| author | Sare, Gillian M. Ali, Myzoon Shuaib, Ashfaq Bath, Philip M.W. |
| author_facet | Sare, Gillian M. Ali, Myzoon Shuaib, Ashfaq Bath, Philip M.W. |
| author_sort | Sare, Gillian M. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background and Purpose—High blood pressure (BP) is associated independently with poor outcome after acute ischemic stroke, although in most analyses “baseline” BP was measured 24 hours or more postictus, and not during the hyperacute period.
Methods—Analyses included 1722 patients in hyperacute trials (recruitment 8 hours) from the Virtual Stroke
International Stroke Trial Archive (VISTA) Collaboration. Data on BP at enrolment and after 1, 2, 16, 24, 48, and 72
hours, neurological impairment at 7 days (NIHSS), and functional outcome at 90 days (modified Rankin scale) were
assessed using logistic regression models, adjusted for confounding variables; results are for 10-mm Hg change in BP. Results—Mean time to enrolment was 3.7 hours (range 1.0 to 7.9). High systolic BP (SBP) was significantly associated
with increased neurological impairment (odds ratio, OR 1.06, 95% confidence interval, 95% CI 1.01 to 1.12), and poor functional outcome; odds ratios for both increased with later BP measurements made at up to 24 hours poststroke. Smaller (versus larger) declines in SBP over the first 24 hours were significantly associated with poor NIHSS scores (OR 1.16, 95% CI 1.05 to 1.27) and functional outcome (OR 1.23, 95% CI 1.13 to 1.34). A large variability in SBP was also associated with poor functional outcome.
Conclusions—High SBP and large variability in SBP in the hyperacute stages of ischemic stroke are associated with
increased neurological impairment and poor functional outcome, as are small falls in SBP over the first 24 hours. |
| first_indexed | 2025-11-14T18:14:10Z |
| format | Article |
| id | nottingham-1081 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T18:14:10Z |
| publishDate | 2009 |
| publisher | American Heart Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-10812020-05-04T20:26:18Z https://eprints.nottingham.ac.uk/1081/ Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration Sare, Gillian M. Ali, Myzoon Shuaib, Ashfaq Bath, Philip M.W. Background and Purpose—High blood pressure (BP) is associated independently with poor outcome after acute ischemic stroke, although in most analyses “baseline” BP was measured 24 hours or more postictus, and not during the hyperacute period. Methods—Analyses included 1722 patients in hyperacute trials (recruitment 8 hours) from the Virtual Stroke International Stroke Trial Archive (VISTA) Collaboration. Data on BP at enrolment and after 1, 2, 16, 24, 48, and 72 hours, neurological impairment at 7 days (NIHSS), and functional outcome at 90 days (modified Rankin scale) were assessed using logistic regression models, adjusted for confounding variables; results are for 10-mm Hg change in BP. Results—Mean time to enrolment was 3.7 hours (range 1.0 to 7.9). High systolic BP (SBP) was significantly associated with increased neurological impairment (odds ratio, OR 1.06, 95% confidence interval, 95% CI 1.01 to 1.12), and poor functional outcome; odds ratios for both increased with later BP measurements made at up to 24 hours poststroke. Smaller (versus larger) declines in SBP over the first 24 hours were significantly associated with poor NIHSS scores (OR 1.16, 95% CI 1.05 to 1.27) and functional outcome (OR 1.23, 95% CI 1.13 to 1.34). A large variability in SBP was also associated with poor functional outcome. Conclusions—High SBP and large variability in SBP in the hyperacute stages of ischemic stroke are associated with increased neurological impairment and poor functional outcome, as are small falls in SBP over the first 24 hours. American Heart Association 2009-06 Article PeerReviewed Sare, Gillian M., Ali, Myzoon, Shuaib, Ashfaq and Bath, Philip M.W. (2009) Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration. Stroke, 40 (6). pp. 2098-2103. ISSN 1524-4628 http://stroke.ahajournals.org/cgi/content/full/40/6/2098 doi:10.1161/STROKEAHA.108.539155 doi:10.1161/STROKEAHA.108.539155 |
| spellingShingle | Sare, Gillian M. Ali, Myzoon Shuaib, Ashfaq Bath, Philip M.W. Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration |
| title | Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration |
| title_full | Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration |
| title_fullStr | Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration |
| title_full_unstemmed | Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration |
| title_short | Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration |
| title_sort | relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the vista collaboration |
| url | https://eprints.nottingham.ac.uk/1081/ https://eprints.nottingham.ac.uk/1081/ https://eprints.nottingham.ac.uk/1081/ |