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BP Dysregulation Linked with Poor Stroke Outcome

Neurology; ePub 2017 Jan 25; Kidwell, et al

Results of a recent study support the hypotheses that acute blood pressure (BP) dysregulation is associated with the development of diffusion-weighted imaging (DWI) lesions in primary intracerebral hemorrhage (ICH) and that DWI lesions are, in turn, associated with poor outcomes. Researchers conducted the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study, a multicenter, observational study of ICH among white, black, and Hispanic patients. They found:

  • Of 600 patients, mean (±SD) age was 60.8 ± 13.6 years, median ICH volume was 9.1 mL (3.5–20.8), and 79.6% had hypertension.
  • Overall, 26.5% of cases had DWI lesions, and this frequency differed by race/ethnicity (black 33.8%, Hispanic 24.9%, white 20.2%).
  • A logistic regression model of variables associated with DWI lesions included lower age, higher first recorded systolic BP, greater change in mean arterial pressure (MAP) prior to the MRI, micro bleeds, and higher white matter hyperintensity (WMH) score after controlling for race/ethnicity, leukocyte count, and acute in-hospital antihypertensive treatment.

Citation:

Kidwell CS, Rosand J, Norato G, et al. Ischemic lesions, blood pressure dysregulation, and poor outcomes in intracerebral hemorrhage. [Published online ahead of print January 25, 2017]. Neurology. doi:10.1212/WNL.0000000000003630.