Differing Aspects of Pre-Stroke and Post-Stroke Hypertension
Some data on pre-stroke and post-stroke hypertension in a descriptive epidemiological study of stroke in The Netherlands are presented. All stroke cases in a community of 152.063 inhabitants were registered from 1978 to 1981.
In the 737 strokes occurring during the study period (cerebral infarction 82 %, intracranial hemorrhage 15 %) 59 % of patients had a history of pre-stroke hypertension. Almost no difference in percentages of pre-stroke hypertension was noted among the major types of stroke. Shortly after their stroke 93 % of assessed cases were markedly hypertensive. Post-stroke hypertension was found less frequently when viewing diastolic pressures than when considering the combined systolic and diastolic ones. The overall distributions of combined systolic and diastolic blood pressure did not differ significantly by stroke type. No association was observed between stroke type and level of systolic pressure. Post-stroke hypertension declined during the next days after stroke, gradually approaching a stable baseline. If treated, it proved to be refractory to control by antihypertensive drugs.
The significantly differing percentages of pre- and post-stroke hypertension seem to reflect the direct influence of stroke on cerebral mechanism of blood pressure control.
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