Delgado-Mederos E, Ribo M, Rovira A, et al. Prognostic significance of blood pressure variability after thrombolysis in acute stroke. Neurology 2008; 71: 552=558.
80 stroke patients were prospectively studies who had MCA occlusion treated with t-pa.Multiple BP measurements were obtained. Recanalization was assessed with TCD at six hours. NIHSS was done at baseline and 24 hours, MRS at 3 months.
55 % were recanalized. Both SBP and DBP variability were highly associated with DWI growth (done before and 36 hours after thrombolysis) and outcome, but only in patients who failed to recanalize
Notes-- There was a significant decline in overall SBP and DBP in recanalized but not unrecanalized patients. However BP variability was the only factor corresponding to DWI growth. Authors speculate that treating the swings is as important as treating the outlying numbers.
Blogger comment-- this observational study is interesting but not powerful enough to be determinant
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