HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in Neurology Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rodríguez-Yáñez, M. Articles by Castillo, J. Search for Related Content PubMed PubMed Citation Articles by Rodríguez-Yáñez, M. Articles by Castillo, J. Related Collections All Cerebrovascular disease/Stroke Infarction All epidemiology

New-onset hypertension and inflammatory response/poor outcome in acute ischemic stroke

From the Department of Neurology, Stroke Unit, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain (M.R.-Y., M.B., R.L., J.C.); Department of Neurology, Stroke Unit (M.C., J.S.), and Unit of Biostatistics, Hospital Doctor Josep Trueta, Girona, Spain (M.M.G.); Department of Neurology, Stroke Unit (F.N.), Hospital de la Princesa, Madrid, Spain; Department of Pharmacology, School of Medicine, University Complutense, Madrid, Spain (I.L.); and Department of Neurology, Stroke Unit, Hospital Trias i Pujol, Barcelona, Spain (A.D.).

Address correspondence and reprint requests to Dr. José Castillo, Department of Neurology, Hospital Clínico Universitario, c/ Travesa da Choupana, s/n, 15706 Santiago de Compostela, Spain; e-mail: mecasti{at}usc.es

Objective: To study the association of previously unknown high blood pressure (HBP) during the acute phase of stroke (new-onset hypertension) with the inflammatory response and clinical outcome.

Methods: We classified 844 patients with hemispheric ischemic stroke into three groups according to history of hypertension and presence of HBP within the first 24 hours after symptom onset: Group I (n = 412), normotensive patients; Group II (n = 265), chronic hypertensive patients; and Group III (n = 167), new-onset hypertensive patients. Interleukin 6 (IL-6), tumor necrosis factor (TNF-), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), and metalloproteinase 9 (MMP-9) were measured in blood samples obtained on admission. The influence of new-onset HBP and markers of inflammation on poor neurologic outcome at 3 months was evaluated by logistic regression analysis.

Results: New-onset HBP was found in 19.9% of patients. Patients in this group had higher plasma concentrations of IL-6, TNF-, ICAM-1, VCAM-1, and MMP-9 than the other two groups. New-onset HBP was associated with poor outcome at 3 months (odds ratio [OR] 2.10; 95% CI 1.54 to 3.52; p < 0.0001) after adjustment for other prognostic factors. However, when markers of inflammation were included in the model, IL-6 (OR 1.01; 95% CI 1.00 to 1.03; p = 0.020) and MMP-9 (OR 1.01; 95% CI 1.00 to 1.01; p < 0.0001), but not new-onset HBP, were independently associated with poor neurologic outcome.

Conclusions: New-onset high blood pressure in acute ischemic stroke, but not chronic hypertension, is associated with an inflammatory response and poor neurologic outcome.

Disclosure: The authors report no conflicts of interest.

Received December 27, 2005. Accepted in final form August 24, 2006.

Related articles in Neurology:

December 12 Highlights

Neurology 2006 67: 1908-1909. [Full Text]