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(Stroke. 2004;35:2436.)
© 2004 American Heart Association, Inc.

Letters to the Editor

Association Between Pulse Pressure Values During the Acute Stroke Stage and Stroke Outcome

Acute Stroke Unit, Department of Clinical Therapeutics, University of Athens, Athens, Greece

Georgios Tsivgoulis, MD Konstantinos Spengos, MD

Department of Neurology, University of Athens, Athens, Greece

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

We read with great interest the recent Research Report by Aslanyan et al.¹ The authors reported that elevated weighted average pulse pressure (PP) during the first 60 hours of ischemic stroke was independently associated with poor outcome assessed by mortality, Barthel index, National Institutes of Health Stroke Score and modified Rankin Scale score. Elevated baseline PP was associated with Barthel Index and Rankin score but not with mortality. Weighted average PP was the only blood pressure (BP) component to be consistently associated with all outcome measures.

We have also evaluated the prognostic value of the different BP components in 198 patients with acute stroke (146 cases with cerebral infarction and 42 cases with intracerebral hemorrhage) by means of 24-hour BP-monitoring.² Our results indicated an independent association between increasing 24-hour PP levels and 1-year mortality after correcting for stroke risk factors, stroke subtypes, clinical (stroke severity and level of consciousness) and radiological characteristics (brain edema, mass effect and hemorrhagic transformation). Higher PP levels on hospital admission were related to an increased risk of 1-year mortality on univariate analysis, but in the multivariate Cox-regression model this association did not retain its statistical significance. This finding underlines the superiority of 24-hour BP variables over admission BP measurements in predicting stroke outcome. It is in keeping with the results of Aslanyan et al and other investigators, which indicate that variables describing BP course during the acute stroke period, such as 24-hour,^2,3,4 beat-to-beat⁵ and weighted average¹ BP recordings correlate more strongly and . . . [Full Text of this Article]