Blood pressure and clinical outcome among patients with acute stroke in Inner Mongolia, China

Objectives The association between blood pressure and short-term clinical outcome of acute stroke is inconclusive. We studied the association between admission blood pressure and in-hospital death or disability among acute stroke patients in Inner Mongolia, China. Methods A total of 2178 acute ischemic stroke and 1760 hemorrhagic stroke patients confirmed by a computed tomography scan or magnetic resonance imaging were included in the present study. Blood pressure and other study variables were collected within the first 24 h of hospital admission. Clinical outcomes were evaluated by trained neurologists during hospitalization. Results The in-hospital case-fatality rate was higher for acute hemorrhagic stroke (5.9%) than it was for acute ischemic stroke (1.8%), whereas the disability rate was higher for those with acute ischemic stroke (41.3%) than those with acute hemorrhagic stroke (34.4%) at discharge. Blood pressure at admission was not significantly associated with clinical outcome in acute ischemic stroke. On the contrary, systolic and diastolic blood pressures were significantly and positively associated with odds of death or disability in acute hemorrhagic stroke. For example, compared to those with a systolic blood pressure less than 140 mmHg, multiple-adjusted odds ratio (95% confidence interval) of death/disability was 1.38 (0.96, 1.99), 1.42 (1.00, 2.03), 1.84 (1.28, 2.64), and 1.91 (1.35, 2.70) among participants with systolic blood pressure 140-159, 160-179, 180-199, and at least 200 mmHg, respectively ( P < 0.0001 for linear trend). Conclusion Increased systolic and diastolic blood pressure were significantly and positively associated with death and disability among patients with acute hemorrhagic stroke, but not acute ischemic stroke, in Inner Mongolia, China.