Hypertension profile in patients with cerebro vascular disease
Keywords:
hypertension, cerebrovascular disease, stroke, TIA, risk factorAbstract
Introdution: hypertension is the most important modifiable risk factor for cerebrovascular disease.
Some studies show that 25 to 40% of the population with cerebrovascular disease has hypertension while others show that the prevalence of hypertension in patients with cerebrovascular disease is 80%.
It would be desirable to understand hypertension past history and evolution in patients with cerebrovascular disease.
Objective: evaluate the hypertensive profile in patients with different types of cerebrovascular disease (intracerebral hemorrhage - IH; ischaemic stroke.- IS; transient ischaemic attack - TIA). Examine hypertension evolution six months after stroke / AIT.
Definition: prospective study in 470 patients with sufficient protocolled medical information, with stroke or TIA admitted to an Internai Medicine department (Hospital S. José, Lisbon).
Methods: medical examination was performed and ali patients had different complementary exams done, including a computerised tomography scan of the brain.
Hypertension was defined as systolic blood pressure than 160 mmHg andlor diastolic blood pressure than 95 mmHg on at least two different occasions or any previous treatment with antihypertensive drugs.
We individualised three subtypes of stroke: IH, IS and TIA. For each subtypewe evaluated: age, sex history of hypertension, classification of hypertension by blood pressure levei, control profile of hypertension during acute stoke, blood pressure levei six months after stroke.
Results : in the entire population (N = 470) hypertension was more prevalent in IH {91.5%) than in IS {69.5%} or TIA {61.3%}. Global prevalence of hypertension is high {67.2%}, 68% of patients did not have controlled hypertension during acute stroke.
The average duration of hypertension before stroke is 104 months.
Hypertension began before and at a higher levei of blood pressure in IH than in IS.
Six months after acute stroke, hypertension was no controlled in 66.5% of patients.
Conclusions: The prevalence of HTA in the 470 patients with the first AVC I TIA was high and the
HTA was no controlled in the stroke. Risk of stroke was clearly related to eficiency of blood pressure control with treatment.
Hypertension was very frequent and had a much greater impact in risk of IH.
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