Published Online
on April 8, 2004

A more recent version of this article appeared on June 1, 2004

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Submitted on January 30, 2004
Accepted on February 10, 2004

Elevated Pulse Pressure During the Acute Period of Ischemic Stroke Is Associated with Poor Stroke Outcome

Stella Aslanyan MD^*; Christopher J. Weir PhD; Kennedy R. Lees MD, FRCP; for the GAIN International Steering Committee and Investigators

From Division of Cardiovascular and Medical Sciences (S.A., C.J.W., K.R.L.) and Robertson Centre for Biostatistics (C.J.W.), University of Glasgow, Scotland.

^* To whom correspondence should be addressed. E-mail: stella_s_aslanyan{at}hotmail.com.

Background--It is controversial which component of blood pressure (BP) during acute period of stroke best predicts outcome. We hypothesized that elevated pulse pressure (PP), the difference between systolic BP (SBP) and diastolic BP (DBP), is independently associated with poor stroke outcome at 3 months.

Methods--We analyzed both treatment groups from the Glycine Antagonist (Gavestinel) in Neuroprotection (GAIN) International trial (1455 ischemic stroke cases of mostly moderate severity). Cox proportional hazards and logistic regression modeling corrected for demography, medical history, heart rate, stroke severity, and clinical subtype.

Results--Elevated weighted average PP during the first 60 hours was associated with poor outcome by mortality, Barthel index, National Institutes of Health Stroke Score (NIHSS) and Rankin scores. Elevated baseline PP was associated with Barthel index and Rankin score.

Conclusion--Elevated PP is associated with poor stroke outcome at 3 months.

Key words: ischemia • stroke • outcome

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