The Relationship of Continous 24-Hour Admission Blood Pressure To Severity and Short-Term Outcome Amongst Stroke Patients At The University of Abuja Teaching Hospital, Abuja, Nigeria.

Objective: To determine the relationship of continuous 24-hour admission blood pressure to stroke severity and 30-days’ mortality and functional outcome amongst survivors in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). Background: Admission blood pressure (BP) is a major determinant of stroke severity and short-term outcome following all strokes. Accurate assessment of blood pressure in the acute post stroke period is crucial for proper stroke management. Design/Methods: 63 AIS and 77 ICH patients were assessed within 72-hours of event with continuous ambulatory blood pressure monitors (ABPM-50) to generate 24-hour blood pressure recordings. Admission NIH Stroke Score determined severity (NIHSS ≥ 15 defined severe stroke) and outcome by 30-day case fatality or by independence amongst stroke survivors according to Modified Rankin Scale (MRS > 3 defined unfavorable outcome). Results: 24-hour continuous blood pressure variables (CBPV) were higher and showed significant and positive correlation to stroke severity in ICH patients but significantly inverse and lower CBPV in AIS All CBPV were significantly higher in ICH but lower in AIS patients with poor outcome expressed as 30-day mortality. However, of these CBPV, Average-(Avr) day-time DBP [odds ratio (OR), 0.944; 95% confidence interval (CI), 0.893–0.998], Minimum 24-hour SBP [OR, 0.872; 95% CI, 0.779 – 0.981] and Minimum 24-hour DBP [OR, 1.148; 95% CI, 1.010 – 1.304] in AIS and Maximum 24-hour DBP [OR, 0.996; 95% CI, 0.996 – 1.115] in ICH significantly predicted mortality. No CBPV predicted independence at 30-days in either AIS or ICH, however a non-significant trend with unfavorable functional outcome was observed with elevated CBPV in ICH and lower CBPV in AIS. Conclusions: In addition to the prognostic significance of continuous blood pressure measures in stroke outcome, individual blood pressure variables may become potential targets for anti-hypertensive intervention. Disclosure: Dr. Ani-Osheku has nothing to disclose. Dr. Danesi has nothing to disclose. Dr. Okubadejo has nothing to disclose. Dr. Alabi has nothing to disclose.