Higher baseline systolic and diastolic blood pressures are
associated with better outcomes after acute ischemic stroke,
according to a report in the December issue of Stroke.

Blood pressures are commonly elevated after an acute ischemic
stroke, the authors explain, but the prognostic significance of the
short-term profile of blood pressure after stroke remains unclear.

Mei Yong from Heinrich Heine University, Dsseldorf, Germany and
colleagues investigated the relationship between blood pressure
level and variability and outcomes in 615 patients with acute
ischemic stroke.

Higher baseline systolic blood pressure was associated with a 22%
higher probability of favorable outcome in 90 days, the authors
report. Similarly, higher baseline diastolic blood pressure was
associated with a 22% higher probability of favorable outcome in 90
days.

Decreased variability in diastolic blood pressure independently
predicted a more favorable 90-day outcome, the report indicates, but
systolic blood pressure variability was not an independent predictor
of outcomes.

"The findings of the present study suggests that it may be
beneficial to keep the blood pressure at a reasonable lower overall
level and less variable over time in the early phase after acute
stroke," the authors conclude. "In clinical practice, this means
that drugs potentially resulting in a sudden drop of blood pressure
or drugs with a short half-life and therefore variable efficacy
should be avoided."

"The clinical relevance of blood pressure level and variability for
the blood pressure management in acute stroke still requires further
investigations," the investigators add. "Our results, as well as
those of [others], suggest that the present guidelines for blood
pressure treatment and acute stroke may need some revisions, and
also the state of arteries should be taken in consideration."

Stroke 2005;36:2619-2625