DOI: https://doi.org/10.30841/2307-5112.1.2018.135313

Characteristics of acute ischemic stroke depending on the structure of gravity and the duration of arterial hypertension

Т. М. Черенько, Ю. Л. Гелетюк

Abstract


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.

Keywords


ischemic stroke; neurological deficit; structure of severity and duration of arterial hypertension

References


Артеріальна гіпертензія. Уніфікований клінічний протокол первинної, екстреної та вторинної (спеціалізованої) медичної допомоги 2012 // Новости медицины и фармации. – 2012. – № 11 (421). http://www.mif-ua.com/archive/article/31084

Бююль А., Цефель П. SPSS: искусство обработки информации. Анализ статистических данных и восстановление скрытых закономерностей // ДиаСофт. – 2005. – 608 с.

Asdaghi N., Pearce L., Nakajima M., Field T., Bazan C., Cermeno F., McClure L., Anderson D., Hart R., Benavente O. Clinical Correlates of Infarct Shape and Volume in Lacunar Strokes The SPS3 Trial. Stroke. 2014 Oct; 45 (10): 2952–2958. https://dx.doi.org/10.1161%2FSTROKEAHA.114.005211

Bill O, Zufferey P, Faouzi M, Michel P. Severe stroke: patient profile and predictors of favorable outcome. J Thromb Haemost 2013; 11: 92–9. https://doi.org/10.1111/jth.12066

Chi-Hung Liu, Yi-Chia Wei, Jr-Rung Lin, Chien-Hung Chang, Ting-Yu Chang, Kuo-Lun Huang, Yeu-Jhy Chang, Shan-Jin Ryu, Leng-Chieh Lin, Tsong-Hai Lee, corresponding author and the Stroke Registry in Chang Gung Healthcare System (SRICHS). Initial blood pressure is associated with stroke severity and is predictive of admission cost and one-year outcome in different stroke subtypes: a SRICHS registry study. BMC Neurol. 2016; 16: 27. https://dx.doi.org/10.1186%2Fs12883-016-0546-y

Corso G., Bottacchi E., Tosi P., Caligiana L., Lia C., Morosini M., Dalmasso P. Outcome Predictors in First-Ever Ischemic Stroke Patients: A Population-Based Study. International Scholarly Research Notices. Volume 2014 (2014), Article ID 904647, 8 p. https://dx.doi.org/10.1155%2F2014%2F904647

Gillian M. Sare, Philip M.W. Bath, Laura J. Gray et al. The Relationship Between Baseline Blood Pressure and Computed Tomography Findings in Acute Stroke. Data From the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST). Stroke. 2009;40:41–46. https://doi.org/10.1161/STROKEAHA.108.526665

Jackson C, Sudlow C. Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts. Stroke 2005;36:891–901. https://doi.org/10.1161/01.STR.0000157949.34986.30

Kirshner H.S. Differentiating ischemic stroke subtypes: Risk factors and secondary prevention. Journal of the Neurological Sciences 279 (2009) 1–8. https://doi.org/10.1016/j.jns.2008.12.012

Kvistad CE, Logallo N, Oygraden H, Thomassen L, Waje-Andreassen U, Naess H. Elevated admission blood pressure and stroke severity in acute ischemic stroke: the Bergen Norstroke Study. Cerebrovasc Dis 2013: 36 (5–6): 351–354. https://doi.org/10.1159/000355685

Madden KP, Karanjia PN, Adams HP Jr, Clarke WR. Accuracy of initial stroke subtype diagnosis in the TOAST study. Trial of ORG 10172 in Acute Stroke Treatment. Neurology. –1995. – № 11. – С. 75–79. https://doi.org/10.1212/WNL.45.11.1975

Manabe Y., Kono S., Tanaka T., Narai H., Omori N. High blood pressure in acute ischemic stroke and clinical outcome. Neurol Int. 2009: 16; 1 (1): e1. https://doi.org/10.4081/ni.2009.e1

Matsumoto M., Sakaguchi M., Okazaki S., Hashikawa K., Takahashi T., Matsumoto M., Ohtsuki T., Shimazu T., Yoshimine T., Mochizuki H., Kitagawa K. Relationship Between Infarct Volume and Prothrombin Time-International Normalized Ratio in Ischemic Stroke Patients With Nonvalvular Atrial Fibrillation Circulation Journal. Volume 81 (2017) Issue 3 Pages 391–396. https://doi.org/10.1253/circj.CJ-16-0707

Nunes A., Dias L., Ribeiro J., Gomes V., Baptista A. Perfil hipertensivo dos doentes com doenҫa vascular cerebral. Medicina Interna. – 2000. – Vol. 7, № 1. – Р. 13–19.

Odderson IR. The National Institutes of Health Stroke Scale and its importance in acute stroke management. Phys Med Rehabil Clin N Am. 1999: 10(4):787–800.

Zaki Noah Hasan, Mousa Qasim Hussein, and Ghazi Farhan Haji. Clinical Study Hypertension as a Risk Factor: Is It Different in Ischemic Stroke and Acute Myocardial Infarction Comparative Cross-Sectional Study? SAGE-Hindawi Access to Research International Journal of Hypertension. Volume 2011, Article ID 701029, 5 pages. https://dx.doi.org/10.4061%2F2011%2F701029

Zbigniew G., Maciej S., Lewandowski J. Blood Pressure Control and Primary Prevention of Stroke: Summary of the Recent Clinical Trial Data and Meta-Analyses. Curr Hypertens Rep (2013). 15:559–574. https://dx.doi.org/10.1007%2Fs11906-013-0401-0




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