The Relation of Blood Pressure to Stroke Prognosis

Abstract

The relation between blood pressure before stroke and survival after the event was examined in the Manitoba [Canada] study cohort of 3983 men. The last recorded blood pressure before the 1st stroke and the change in blood pressure from a measurement 5 yr earlier were used. Increasing magnitude of systolic blood pressure and its 5 yr changes were associated with worsening prognosis. The same association was less apparent for diastolic blood pressure and was not found for 5 yr change in diastolic pressure. After adjusting for the effect of age at stroke and previous evidence of ischemic heart disease in multivariate analysis, systolic blood pressure and its 5 yr change were each significant predictors of short-term (30 days) mortality. Considering all these factors as well as diastolic blood pressure, systolic blood pressure was the best predictor of short-term mortality. High blood pressure and large positive 5 yr change in systolic blood pressure before stroke occurrence are significant predictors of a poor prognosis.