Monitoring Blood Pressure in Patients with Acute Stroke

Elevated blood pressure is a well recognised risk factor for cardiovascular events and the positive results of pharmacological intervention trials have confirmed this relationship in primary and secondary prevention. However, our knowledge of the role of blood pressure in the acute phase of stroke is very limited and controversial. Indeed, in some studies no correlation has been found between elevated blood pressure in the early phase of stroke and prognosis, while in other studies of patients with hypertension elevated BP was associated with either a better or worse prognosis. In the limited number of studies that have involved ambulatory blood pressure monitoring (ABPM) the trend has been toward a negative prognostic impact from elevated 24-hour systolic blood pressure. In addition, studies in patients on ABPM after stroke have shown that there are different patterns of night-time blood pressure, and that these are related to the type of cerebral infarction or its location, which could, in part, explain the differences in results so far obtained in studies.