Blood Pressure Management Following Acute Ischemic Stroke

Tucker, Natalie; Stoffel, Jaclyn; Hayes, Lisa; Jones, G. Morgan

doi:10.1097/cnq.0000000000000297

Cited by 4 publications

(3 citation statements)

References 66 publications

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“…An elevated baseline SBP was an independent predictor of END and unfavorable outcomes at 3 months after IVT in mild AIS patients. After the occurrence of ischemic stroke, SBP might remain elevated to maintain constant cerebral perfusion (17). Current guidelines (12) recommend that blood pressure should be controlled (<180/105 mmHg) in the first 24 h after IVT.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Outcomes of Intravenous Thrombolysis in Mild Ischemic Stroke Patients

Tang

Yan

2021

Front. Neurol.

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Objective: This study assessed the characteristics of intravenous thrombolysis (IVT) with respect to early neurological deterioration (END) and functional outcome in mild ischemic stroke patients.Methods: Data were obtained from acute mild ischemic stroke patients (defined as having a National Institute of Health Stroke Score (NIHSS) ≤ 5) treated with IVT in our hospital from July 2017 to December 2020. END was defined as the NIHSS increased ≥1 over the baseline at 24 h after IVT. A modified Rankin scale (mRS) ≤ 1 at 3 months was considered as a favorable outcome, and an mRS ≥2 at 3 months was an unfavorable outcome.Results: Two hundred thirty-three acute mild ischemic stroke patients (all patients underwent MRI and DWI restriction) with IVT were included in this study. Thirty-one patients experienced END, and 57 patients experienced an unfavorable outcome at 3 months. With multivariate analysis, END was associated with an elevated baseline systolic blood pressure (SBP) (OR = 1.324, 95% CI, 1.053–1.664, p = 0.016) and coronary heart disease (OR = 4.933, 95% CI, 1.249–19.482, p = 0.023). An unfavorable outcome at 3 months after IVT was independently associated with a baseline elevated SBP (OR = 1.213, 95% CI, 1.005–1.465, p = 0.045), baseline NIHSS (OR = 1.515, 95% CI, 1.186–1.935, p = 0.001), prior hyperlipemia (OR = 3.065, 95% CI, 1.107–8.482, p = 0.031), cardioembolic stroke (OR = 0.323, 95% CI, 0.120–0.871, p = 0.025), and END at 24 h (OR = 4.531, 95% CI, 1.950–10.533, p < 0.001) in mild ischemic stroke patients.Conclusion: In mild ischemic stroke patients with IVT, an elevated baseline SBP and coronary heart disease were associated with END. The elevated baseline SBP, baseline NIHSS, a history of prior hyperlipemia, cardioembolic stroke, and END at 24 h after IVT were useful in predicting an unfavorable outcome at 3 months.

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Section: Discussionmentioning

confidence: 99%

Characteristics and Outcomes of Intravenous Thrombolysis in Mild Ischemic Stroke Patients

Tang

Yan

2021

Front. Neurol.

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“…Acute IS is characterized by a sudden onset and a heightened risk of disability, particularly in the elderly population. The current demographic shift towards an aging society in our country accentuates the severity of this issue, making acute IS a leading cause of mortality and disability among residents[ 17 , 18 ]. IS encompasses stroke resulting from ischemia and hypoxia as well as acute cerebral infarction caused by hemorrhage, carrying a substantial fatality rate and unfavorable prognosis.…”

Section: Discussionmentioning

confidence: 99%

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

Hu,

Sang,

Xiao

2024

World J Clin Cases

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BACKGROUND Ischemic stroke (IS) is a widely recognized disease characterized by high prevalence, mortality, morbidity, disability, and recurrence rates. It ranks prominently in terms of mortality, constituting 60%-80% of stroke cases. AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS. METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021. The participants were divided into two groups, namely the control group (n = 80) receiving routine care and the research group (n = 92) receiving comprehensive care. Various assessment scales, including the standard swallowing function assessment scale (SSA), National Institutes of Health Stroke scale (NIHSS), European stroke scale (ESS), self-rating anxiety scale (SAS), self-rating depression scale (SDS), Barthel index (BI), and the motor function assessment scale (MAS), were employed to evaluate the improvement in swallowing function, neurological deficits, clinical outcomes, anxiety, depression, daily living activities, and motor function before and after care. Furthermore, the study compared the occurrence of adverse reactions during the nursing period, life quality before and after the intervention, rehabilitation compliance, and nursing satisfaction between the two groups. RESULTS After the nursing intervention, the research group exhibited significantly improved SSA and NIHSS scores compared to the control group (P < 0.05). Moreover, both groups demonstrated significant reductions in SAS and SDS scores (P < 0.05), with the research group showing more obvious advantages (P < 0.05). Compared to the control group, the research group displayed significantly better ESS, BI, and MAS scores (P < 0.05), coupled with a lower incidence of adverse reactions (P < 0.05). Additionally, the research group demonstrated markedly higher levels of life quality, rehabilitation compliance, and nursing satisfaction compared to the control group (P < 0.05). CONCLUSION Comprehensive nursing effectively improved swallowing function, quality of life, and patient satisfaction, highlighting its clinical significance.

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“…31 Following an ischemic stroke, the body may increase systolic blood pressure to ensure constant cerebral perfusion. 32 While the mechanism by which SBP promotes the onset of END is unclear, one study discovered that MMP-9 and AQP-4 levels were proportional to 24 h of blood pressure after IVT, therefore, they hypothesized that the onset of END may be related to the disruption of the blood-brain barrier induced by oxidative stress and the upregulation of AQP-4. 33 Conversely, elevated SBP poses a heightened risk of cerebral edema, hemorrhagic transformation, and stroke recurrence, all of which are closely linked to an unfavorable prognosis in individuals with ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

Machine Learning Models for Predicting Early Neurological Deterioration and Risk Classification of Acute Ischemic Stroke

Yang,

Lv,

Wang

et al. 2023

Clin Appl Thromb Hemost

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This study aimed to create machine learning models for predicting early neurological deterioration and risk classification in acute ischemic stroke (AIS) before intravenous thrombolysis (IVT). The study included 704 AIS patients categorized into END and non-END groups. The least absolute shrinkage and selection operator (LASSO) regression was employed to select the best predictors from clinical indicators, leading to the creation of Model 1. Univariate and multivariate logistic regression analyses identified independent predictive factors for END from inflammatory cell ratios. These factors were combined with clinical indicators, forming Model 2. Receiver operating characteristic (ROC) curves assessed the models’ predictive performance. Key variables for Model 1 included the NIHSS score, systolic blood pressure, and lymphocyte percentage. Neutrophil-to-Lymphocyte ratio, Platelet-to-Neutrophil ratio, and Platelet-to-Lymphocyte ratio independently predicted END. Model 1 exhibited moderate predictive ability (AUC 0.721 in training, AUC 0.635 in test). Model 2, which integrated clinical indicators and inflammatory cell ratios, demonstrated strong performance in both training (AUC 0.862) and test (AUC 0.816). Machine learning models, combining clinical indicators and inflammatory cell ratios before IVT, accurately predict END and associated risk in AIS.

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Blood Pressure Management Following Acute Ischemic Stroke

Cited by 4 publications

References 66 publications

Characteristics and Outcomes of Intravenous Thrombolysis in Mild Ischemic Stroke Patients

Characteristics and Outcomes of Intravenous Thrombolysis in Mild Ischemic Stroke Patients

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

Machine Learning Models for Predicting Early Neurological Deterioration and Risk Classification of Acute Ischemic Stroke

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