Abstract：
OBJECTIVE: The management of blood pressure (BP) and the role of antihypertensive medications (AHT) in acute ischemic stroke (AIS) remain uncertain. This study aimed to investigate the impact of pre- and intra-stroke AHT use on systolic (SBP), diastolic (DBP), and blood pressure variability (BPV).
METHODS: A post-hoc analysis was conducted on 228 AIS patients from the PREVISE study. All patients underwent 24-hour ambulatory blood pressure monitoring within 48 h of symptom onset. Clinical and laboratory data, as well as AHT details, were recorded. Mean BP parameters and BPV for SBP and DBP were computed. The study endpoint was 3-month mortality.
RESULTS: The majority of stroke patients (84.2%) were already taking AHTs. Beta blockers and ACE inhibitors use before and after stroke were linked to higher DBP variability. Prior angiotensin receptor blockers (ARBs) and vasodilators use correlated with increased SBP variability and lower daytime SBP/DBP levels, respectively. The continuation, discontinuation, or change of AHTs after stroke onset did not significantly affect outcomes. Patients under AHTs during AIS exhibited reduced mortality, with those previously using calcium channel blockers experiencing less severe strokes, and those previously using ARBs showing better outcomes at three months.
CONCLUSIONS: These findings advocate for personalized BP management in AIS, based on a patient\'s antihypertensive history. These insights could enhance treatment efficacy, guide research, and improve care for acute ischemic stroke patients.
METHODS: A post-hoc analysis was conducted on 228 AIS patients from the PREVISE study. All patients underwent 24-hour ambulatory blood pressure monitoring within 48 h of symptom onset. Clinical and laboratory data, as well as AHT details, were recorded. Mean BP parameters and BPV for SBP and DBP were computed. The study endpoint was 3-month mortality.
RESULTS: The majority of stroke patients (84.2%) were already taking AHTs. Beta blockers and ACE inhibitors use before and after stroke were linked to higher DBP variability. Prior angiotensin receptor blockers (ARBs) and vasodilators use correlated with increased SBP variability and lower daytime SBP/DBP levels, respectively. The continuation, discontinuation, or change of AHTs after stroke onset did not significantly affect outcomes. Patients under AHTs during AIS exhibited reduced mortality, with those previously using calcium channel blockers experiencing less severe strokes, and those previously using ARBs showing better outcomes at three months.
CONCLUSIONS: These findings advocate for personalized BP management in AIS, based on a patient\'s antihypertensive history. These insights could enhance treatment efficacy, guide research, and improve care for acute ischemic stroke patients.
摘要：
目的：急性缺血性卒中（AIS）的血压管理和降压药物（AHT）的作用尚不明确。本研究旨在探讨卒中前后使用AHT对收缩压(SBP)的影响。舒张压（DBP），和血压变异性（BPV）。
方法：对PREVISE研究的228例AIS患者进行了事后分析。所有患者在症状发作后48小时内接受24小时动态血压监测。临床和实验室数据，以及AHT细节，被记录下来。计算SBP和DBP的平均BP参数和BPV。研究终点为3个月死亡率。
结果：大多数卒中患者（84.2%）已经服用了AHTs。在卒中前后使用β受体阻滞剂和ACE抑制剂与较高的DBP变异性有关。先前使用血管紧张素受体阻滞剂（ARB）和血管扩张剂与SBP变异性增加和日间SBP/DBP水平降低相关，分别。延续,停药,卒中发病后AHTs或AHTs的变化对结局无显著影响.AIS期间接受AHTs治疗的患者死亡率降低，那些以前使用钙通道阻滞剂的人经历了较不严重的中风，以及以前使用ARB的人在三个月时表现出更好的结果。
结论：这些发现倡导AIS中的个性化BP管理，根据患者的降压病史。这些见解可以提高治疗效果，指导研究,改善急性缺血性脑卒中患者的护理。
方法：对PREVISE研究的228例AIS患者进行了事后分析。所有患者在症状发作后48小时内接受24小时动态血压监测。临床和实验室数据，以及AHT细节，被记录下来。计算SBP和DBP的平均BP参数和BPV。研究终点为3个月死亡率。
结果：大多数卒中患者（84.2%）已经服用了AHTs。在卒中前后使用β受体阻滞剂和ACE抑制剂与较高的DBP变异性有关。先前使用血管紧张素受体阻滞剂（ARB）和血管扩张剂与SBP变异性增加和日间SBP/DBP水平降低相关，分别。延续,停药,卒中发病后AHTs或AHTs的变化对结局无显著影响.AIS期间接受AHTs治疗的患者死亡率降低，那些以前使用钙通道阻滞剂的人经历了较不严重的中风，以及以前使用ARB的人在三个月时表现出更好的结果。
结论：这些发现倡导AIS中的个性化BP管理，根据患者的降压病史。这些见解可以提高治疗效果，指导研究,改善急性缺血性脑卒中患者的护理。
