The course of blood pressure in acute stroke is related to the severity of the neurological deficits

Objectives - To evaluate how soon after stroke the diagnosis of hypertension could be established. Methods - In a prospective study including 1192 patients with acute stroke within 6 h, blood pressure was measured serially at 2-h intervals during the first 24 h. Results are presented as mean arterial blood pressure (MAP). The Scandinavian Stroke Scale (SSS) assessed the neurological deficit. Results - In 779 patients with mild to moderate ischaemic stroke or transient ischaemic attack (TIA) and SSS > 25, MAP was 118 mmHg (CI 95%: 116-119 mmHg) on admission and 109 mmHg (CI 95%: 108-110 mmHg) 4 h later (paired t -test, P < 0.001). No such early decrease was observed in 228 patients with severe cerebral infarction (CI). In mild to moderate ischaemic stroke or TIA, MAP at 24 h was not different from MAP at 3 months in paired t -test. Conclusions - Blood pressure 24 h after admission in patients with mild to moderate CI or TIA was representative of the patient's blood pressure 3 months after stroke. A diagnosis of arterial hypertension can be established a few days after stroke.