• Valentina Giani, Tommaso Valobra, Nicolò Capsoni, Michele Galasso, Lorenzo De Censi, Cecilia Ferretti, Andrea Sultana, Annalisa Giacalone, Ilaria Garofani, Michele Bombelli, Chiara Ceresa, Silvia Gheda, Elio Clemente Agostoni, Filippo Galbiati, Cristina Giannattasio, and Alessandro Maloberti.
• School of Medicine and Surgery, Milan-Bicocca University, Milan, Italy.
• Eur. J. Intern. Med. 2024 Jun 1; 124: 616861-68.

BackgroundFew certainties exist regarding optimal management of Blood Pressure (BP) in the very first hours after an ischemic stroke and many questions remain still unanswered. Our work aimed to evaluate the role of BP and its trend as possible determinants of in-hospital mortality (primary outcome), discharge disabilities and hospitalization length (secondary outcomes) in ischemic stroke patients presented with Hypertensive Emergencies (HE).MethodsWe retrospectively evaluated patients presented to Niguarda Hospital, Emergency Department (ED), from 2015 to 2017 with a neurological ischemic HE. BP at ED presentation (T0), its management in ED (T1) and its values at the stroke unit admission (T2) were evaluated.Results267 patients were included (0.13 % of all ED accesses and 17.9 % of all ischemic strokes). In the whole population, BP values were not associated with in-hospital mortality while T0 and T2 SBP result were associated to discharge disability and hospitalization length. In pre-specified subgroup analysis these associations were confirmed only in untreated subjects (not anti-hypertensive nor thrombolysis). In fact, no significant relationship can be found between BP values and any secondary outcome in thrombolysis and anti-hypertensive treated patients.ConclusionsBP values and its management can not be related to in-hospital mortality in stroke patients, presented with HE, while they are associated to discharge disability and hospitalization length. In subgroup analysis, results were confirmed only in untreated (not anti-hypertensive therapies nor thrombolytic).Copyright © 2024 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

32 keywords...

hide…