The effect of ambulatory blood pressure values on prognosi̇s i̇n hyperacuteperi̇od i̇n pati̇ents wi̇th acute ischemi̇c stroke

Introduction and Objective: Ischemic stroke is a common acute neurological disease with serious morbidity and mortality. Hypertension is one of the most modifiable risk factor of ischemic stroke. We aimed to investigate the effect of ambulatory blood pressure values on prognosis in patients with acute ischemic stroke admitted within the first 12 hours of stroke symptoms. Method: Sixty-one patients with acute ischemic stroke, who were admitted in the first 12 hours of stroke to the Çukurova University Faculty of Medicine Neurology Intensive Care and Stroke Unit between the dates of September 01, 2018 and May 31, 2019 were included in this prospective study. Ambulatory blood pressure and heart rate measurements were performed at night (between 21 p.m.-09 a.m. ) and during the day (between 09 a.m.-21 p.m.). The relationship between the demographic characteristics, ischemic stroke subtypes according to TOAST classification, NIHSS scores at admission and discharge, modified Rankin scale score at discharge and 90th day and ambulatory blood pressure and heart rate values were evaluated. Results: It was found that the mean ambulatory blood pressure values of the patients were higher at night than during the day. Twenty-four hour, day and night mean heart rate values were determined to be higher in the mortality group than the surviving group (p < 0,001). Twenty-four hour mean arterial blood pressure, day and night mean systolic blood pressure values were found to be lower in the group considered as young stroke compared to the group over 55 years old ( p = 0,047, p = 0,033, p = 0,023, respectively). Daytime mean heart rate was found to be significant variables that increase the risk of developing mortality and poor prognosis, and age and stroke severity increasing the risk of developing poor prognosis. In terms of mortality and poor prognosis development, the mean heart rate values of daytime and night were found to be significant predictors. Conclusion: This study showed that ambulatory blood pressure and heart rate measurements of patients with acute ischemic stroke in the hyperacute period may be important indicators of short and long-term prognosis. Key Words: Ambulatory blood pressure measurement, hypertension, acute ischemic stroke, prognosis