Blood pressure after stroke. A one-year follow-up study.

Abstract

Blood pressure changes in the year after acute stroke have been poorly documented. We therefore studied blood pressure for 1 year after discharge from the hospital in 226 consecutive patients (mean age, 73 years) surviving an acute stroke. Marked increases (p < 0.001) in mean systolic and mean diastolic blood pressures were seen in two thirds (69%) of the patients 1 month after discharge, and blood pressure remained stable at this level during the remainder of the follow-up year. Similar blood pressure changes were seen irrespective of sex, final stroke diagnosis, or whether the patient had a history of hypertension before the stroke. Patients with a history of hypertension had significantly higher blood pressures (p < 0.001) throughout the follow-up year than previously normotensive patients. One month after discharge blood pressure was found to have decreased in 31% of the patients; these were older and had a higher mortality during the follow-up year than patients with blood pressure increases. About 20% of all patients suffered from orthostatism (defined as a decrease in systolic blood pressure of > or = 20 mm Hg when rising from the supine position to standing). We conclude that antihypertensive treatment should not be reduced before discharge from the hospital and that blood pressure should be checked about 1 month after discharge. We suggest that standing blood pressure also be measured to make an appropriate treatment decision.