Prior antihypertensive treatment and admission blood pressure correlated with clinical outcome and early morning presentation in hypertensive ischaemic stroke patients

Blood pressure (BP) reduction of 5-6 mm Hg reduces the relative risk of str oke by 30-40%. This effect does not appear to depend on the antihypertensiv e agent used to bring about the required reduction in BP. Patients with acu te ischaemic stroke often exhibit an elevated BP. These patients, who previ ously suffered from hypertension, have significantly higher levels of BP re adings on admission with increased incidence of stroke immediately after ar ising. The aim of this study was to compare antihypertensive agents, especi ally short and long acting drugs with the measurement of BP on admission, t he time of the ischaemic stroke and its clinical severity. This was studied retrospectively in 109 patients (55 females and 54 males), The mean age wa s 69.7 +/- 10.4 years. All the patients admitted between 1 July 1996 and 30 June 1997 for ischaemic stroke as established by brain CT scan, were studi ed. Of the stroke subjects not treated or treated with short acting calcium blockers, 40.8% and 44.4% of them respectively appeared to have an ischaem ic stroke in the early morning hours in contrast to 20% of those treated wi th long acting calcium blockers (P < 0.05). The last group of patients also experienced less clinical severity. These results emphasise the need for proper 24-h control of BP and by compa rison to other antihypertensive agents, the long acting calcium blockers wi th these subjects may prevent a sudden early morning rise in BP, which is i nstrumental in stroke prevention.