BLOOD-PRESSURE MEASUREMENT AND ANTIHYPERTENSIVE THERAPY IN ACUTE STROKE

Inappropriate management of high blood pressure in acute stroke can ad versely affect outcome. We examined blood pressure evaluation and anti hypertensive therapy during the first week post-stroke in 40 patients at a district general hospital with no stroke unit. In the first 24 ho urs, median frequency of blood pressure recording was 3 (range 1-12). After day 1, 11 (28%) had no blood pressure readings for one or two co nsecutive days. The side of measurement was not recorded in any patien t. None of the 22 hypertensives (55%) had a bilateral measurement to e xclude interarm inequality, and only 3 (7%) of all patients had postur al readings to exclude orthostatic hypotension. Fourteen (35%) receive d antihypertensive therapy without meeting recommended indications; so me even had low blood pressure. As most stroke patients are managed in general medical wards rather than stroke units, a greater awareness o f these important aspects of blood pressure evaluation and therapy are needed among medical and nursing staff.