Diurnal blood pressure change varies with stroke subtype in the acute phase.
- 1 August 1998
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 29 (8), 1519-1524
- https://doi.org/10.1161/01.str.29.8.1519
Abstract
Background and Purpose —It is unclear whether acute stroke is associated with a loss of the normal diurnal blood pressure (BP) change and whether stroke type influences this. Some of this confusion results from the use of fixed time definitions of day and night, which can be overcome by the use of cumulative sums analysis (cusums). Methods —Ninety-eight stroke patients had 24-hour BP monitoring (Spacelabs 90207) performed within 48 hours of ictus. Three subgroups were identified: cortical infarct, n=50; subcortical infarct, n=29; and primary intracerebral hemorrhage [PICH], n=19. An age-matched control group of 74 subjects was also studied. Diurnal change was assessed by both day-night differences (absolute and percentage) and cusums (cusums plot height [CPH] and circadian alteration magnitude [CDCAM]); ANCOVA was used to compare groups. Results —Compared with control subjects, cortical infarct and PICH subgroups had significantly reduced mean diurnal systolic changes using day-night differences (absolute, –12 and –17 mm Hg; percentage, –10 and –12, respectively; P P P P P Conclusions —Diurnal BP change was reduced in the 3 stroke subgroups studied, especially in patients with cortical infarcts and PICH. This may reflect damage to the central modulation of autonomic BP control. The implications in terms of prognosis and therapy in the acute period require further study.Keywords
This publication has 27 references indexed in Scilit:
- Blood Pressure Variability and Lacunar StrokeAge and Ageing, 1998
- Early Carotid Atherosclerosis of the Internal and External Carotid Artery Related to Twenty-Four-Hour Blood Pressure VariabilityCerebrovascular Diseases, 1997
- Reproducibility of the circadian systolic blood pressure variation in the elderlyJournal Of Hypertension, 1995
- Cardiac and sympathetic effects of middle cerebral artery occlusion in the spontaneously hypertensive ratBrain Research, 1993
- Cumulative sums in quantifying circadian blood pressure patterns.Hypertension, 1992
- Classification and natural history of clinically identifiable subtypes of cerebral infarctionThe Lancet, 1991
- Accuracy of the SpaceLabs 90207 determined by the British Hypertension Society ProtocolJournal Of Hypertension, 1991
- Bibliography of the current world literature in hypertensionJournal Of Hypertension, 1991
- The Structure of IADL and ADL Measures: Some Findings from a Swedish StudyAge and Ageing, 1991
- Differentiation and investigation of primary versus secondary hypertension (Cushing reflex)The American Journal of Cardiology, 1989