Daily profile of poststroke blood pressure change

Although acute hypertension after stroke is widely recognized, blood pressure changes in relation to the value before stroke onset have been little discussed. We evaluated the daily profile of blood pressure changes from the time before stroke onset through the 14th day after ictus in 38 patients admitted to hospital within 24 hours (7.4 ± 8.8 hours) after a first acute ischemic stroke, whose medical histories, blood pressure measurements, and medications were thoroughly reviewed. The mean arterial blood pressure was 97 ± 13 mm Hg at baseline and 112 ± 17 mm/Hg on admission after ictus. The extent of poststroke blood pressure elevation, (defined as blood pressure on admission after stroke onset less baseline blood pressure at outpatient clinic before stroke onset), and mean daily blood pressure values were calculated through the 14th day after ictus. Three quarter of the subjects had poststroke hypertension, and the extent of poststroke blood pressure elevation correlated significantly with the degree of neurologic recovery (R = 0.43, P < .01). Blood pressure was highest on admission after ictus and fell to the baseline level by day 2 (101 ± 12 mm Hg). Because poststroke blood pressure change resolves spontaneously and is suggestive for neurologic recovery, careful consideration should therefore be given to antihypertensive therapy in patients with acute ischemic stroke.