Relationship between mean arterial pressure on admission and the prognosis of patients with acute ischemic stroke

Abstract

Objective  To explore the relationship between mean arterial pressure (MAP) on admission and prognosis of patients with acute ischemic stroke.  Methods  A total of 342 patients on acute stage (< 24 h) of ischemic stroke were divided into 4 groups according to their MAP levels on admission: < 97 mm Hg, 97- mm Hg, 107- mm Hg and ≥ 117 mm Hg. Ninety days after onset, these patients were divided into 2 groups according to modified Rankin Scale (mRS): favorable prognosis (mRS < 3) and unfavorable prognosis (mRS 3-6). Logistic regression analysis was used to evaluate the effect of MAP at admission on the prognosis 90 d after onset.  Results Patients with unfavorable prognosis in 4 MAP groups (< 97 mm Hg, 97- mm Hg, 107- mm Hg and ≥ 117 mm Hg) accounted for 34.78% (16/46), 14.29% (14/98), 15.32% (17/111) and 41.38% (36/87), respectively. Patients in 97- mm Hg and 107- mm Hg groups presented better prognosis (P < 0.01, for all). In Logistic regression analysis, by optimal modification of systolic blood pressure (SBP) and diastolic blood pressure (DBP), MAP from 97 mm Hg to 107 mm Hg and from 107 mm Hg to 117 mm Hg were independent protective factors for the prognosis 90 d after onset (P = 0.003, 0.011).  Conclusions  Too high or too low MAP in acute stage of ischemic stroke indicates an unfavorable progonsis of patients. Therefore, MAP can be used as predictive indicator of prognosis of patients with acute ischemic stroke.

DOI: 10.3969/j.issn.1672-6731.2015.05.013