• 作者：Luis  ; Castilla-Guerra^a ;   ; ^{castillafernandez@hotmail.com} ; Marí ; a del Carmen  ; Ferná ; ndez-Moreno^b ; Antonio  ; Espino-Montoro^a ; José ; Manuel  ; Ló ; pez-Chozas^c
• 关键词：Ischemic stroke ; Hypertension ; Secondary prevention ; Nocturnal hypotension ; ABPM
• 刊名：European Journal of Internal Medicine
• 出版年：2011
• 出版时间：October 2011
• 年：2011
• 卷：22
• 期：5
• 页码：501-504
• 全文大小：150 K

Background

Methods

We included fifty consecutive patients presenting at our outpatient clinic for review and who had been discharged for IS in the previous six months. 24-h ABPM was performed with Spacelab 90207 monitor. NHP episodes were considered those values on which the mean arterial pressure (MAP) < 70 mm Hg. Patients were divided into two groups according to the presence or absence of NHP.

Results

We studied 31 men and 19 women, mean age 68 ¡À 11 years. Episodes of NHP were observed in 21 patients (42 % ). There were no significant differences with regard to clinical characteristics between groups. With regard to BP, patients with NHP had significantly lower mean 24-hour BPs, mean daytime BPs and mean nighttime BPs. Dipper pattern occurred more often in patients with NHP, although differences were only statistically significant in the diastolic BP values. Mean office readings were 142 ¡À 26/77 ¡À 13 mm Hg (149 ¡À 26 versus 133 ¡À 20; P = 0.06; 82 ¡À 12 versus 71 ¡À 12; P = 0.008). None of the patients showed office SBP < 90 mmHg and only four had office DBP < 60 mmHg.

Conclusions

Episodes of NHP in patients with recent IS are common and difficult to detect with clinical cuff measurements. It is necessary to redefine the target BP levels in secondary stroke prevention, possibly because we are subjecting our patients to increased risk of NHP and cerebral hypoperfusion.