Characteristics of acute ischemic stroke depending on the structure of gravity and the duration of arterial hypertension
Hypertension is one of the main modifiable independent factors of stroke and one of the leading factors that can determine stroke course and its outcome. Evaluation of hypertension severity and duration in patients with acute ischemic stroke of different neurological deficit, pathogenesis, localization and size of the damage area will contribute to adequate prediction of stroke outcome and will improve its prevention.
The objective: to characterize ischemic stroke depending on its clinical and instrumental features in view of the hypertension severity and duration.
Materials and methods. Complex clinical and neurological examination of 150 patients: 74 (49,3%) women and 76 (50,7%) men aged 43 to 80 years (mean age – 67,4Ѓ}0,7 years) with acute ischemic stroke and documented history of arterial hypertension was provided. Stroke severity was assessed using the NIHSS scale. The diagnosis of hypertension, its severity and duration was based on data from clinical, instrumental examination and medical documentation.
Results. Severity of ischemic stroke by the NIHSS scale was 9,5±0,35 points on admission; 57,4% of patients had moderate neurological disorders. The mean anamnestic duration of hypertension was 12,3±0,64 years. Hypertension with its duration more than 6–10 years (46%) was observed the most commonly. Hypertension duration in anamnesis significantly correlated with the severity of neurological deficit on admission. Analysis of the patients differentiation by the hypertension stage showed that almost half of patients had hypertension, stage II – 72 (48,0%), about one third – 48 (32%) patients – hypertension, stage III, in 20% of patients mild hypertension was observed. The relationship between hypertension duration and its degree was moderate and direct, r = 0,592 (p = 0.001), as well as between the NIHSS score and hypertension stage, r = 0,612 (p = 0.001). In case of severe stroke, patients with hypertension, stage III were dominated – 26 (68,4%) (p<0.05). Hypertension, stage I was mainly associated with the development of minor and moderate-severe stroke in most patients – 28 (93,3%).Conclusions. The proportion of hypertension of different stages, both severity and duration, is not the same in stroke patients and depends on the stroke severity. The proportion of hypertension of different stages and duration significantly differed in the pathogenetic stroke subtypes. There was no significant difference in the hypertension duration and its severity structure in patients with different sizes of infarct zones. Hypertension severity and duration in anamnesis significantly affect ischemic stroke severity on admission that require early diagnostics improving, prevention of severe hypertension, and also predetermines further study of the hypertension effect on the stroke outcome.
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