Stroke :: Pulse pressure predicts stroke recurrence

An increase in 24-hour pulse pressure in patients who have undergone a first stroke indicates an increased risk of experiencing another within a year, Greek researchers report.

As investigator Dr. Kostas Spengos told, “the findings of our study suggest that elevated 24-hour pulse pressure levels are independently associated with increased long-term recurrence.”

Spengos and colleagues at the University of Athens followed 339 consecutive patients who underwent 24-hour blood pressure monitoring within a day of their first stroke. The findings are published in the October issue of the Journal of Neurology, Neurosurgery and Psychiatry.

At one year, the stroke recurrence rate was 9.2 percent. The only significant predictors of another stroke were age, diabetes and 24-hour pulse pressure. The risk of stroke recurrence within one year increased by almost one third for every 10 mm Hg increase in blood pressure.

The researchers note that the study was not designed to investigate the underlying mechanisms, but they suggest that medication might help reduce this risk.

However, Spengos added, since blood pressure-lowering drugs effect blood vessel stiffness and “can selectively alter different components of blood pressure,” large, well-designed studies will be needed to confirm if lowering one or more components of blood pressure can improve the outcome of stroke patients.

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