Extreme Blood Pressure Is Bad During Stroke

A study reported in Stroke (February 2004) indicated that both high and low blood pressure during the beginning stages of stroke are connected with brain injury and poor outcome. A decrease in blood pressure, however, seemed to be more harmful. Because no consensus had been reached about how blood pressure should be managed in the acute phase of stroke, Spanish researchers decided to investigate further.

In a study of 258 patients, the researchers examined the relationship of systolic and diastolic blood pressure with outcome during the first 24 hours of a stroke. The results showed that, for every 10 mm below 180 mm Hg in systolic pressure, the chance of early neurologic impairment rose by 6%, the risk of poor outcome increased by 25%, and the risk of death within 3 months rose by 7%. In contrast, however, for every 10-mm increase above 180 mm Hg, the possibility of early neurologic weakening increased by 40% and that of poor outcome increased by 23%. (The change did not affect mortality.) A similar pattern was detected for diastolic pressure above or below 100 mm Hg.