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(Stroke. 2004;35:e153.)
© 2004 American Heart Association, Inc.

Research Reports

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.

Correspondence to Dr S. Aslanyan, Gardiner Institute, Western Infirmary, Glasgow G11 6NT, UK. 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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