Blood pressure, nimodipine, and outcome of ischemic stroke

$48.00 plus tax (Refund Policy)

Download / Buy Article:

Abstract:

Fogelholm R, Palomäki H, Erilä T, Rissanen A, Kaste M. Blood pressure, nimodipine, and outcome of ischemic stroke.

Acta Neurol Scand 2003 DOI: 10.1046/j.1600-0404.2003.00202.x © Blackwell Munksgaard 2003. Objectives –

The reduction of blood pressure (BP) caused by nimodipine has been proposed as an explanation for the poor results in ischemic stroke trials. We evaluated further the relationships between BP, nimodipine, and outcome of ischemic stroke, and also searched for other possible explaining mechanisms. Patients and methods –

All 350 participants of an earlier placebo controlled trial on oral nimodipine were included in this study. Among other variables, the admission BP, and the change of BP during the first day were noted. The 3 week and 3 month functional outcome was assessed with a modified Rankin grading. Results –

The severity of stroke was the utmost important predictor of outcome. Visible cerebral infarction on computed tomography (CT) was associated with severe stroke and an early commencement (within 24 h of stroke onset) of nimodipine treatment. In the nimodipine arm, high initial systolic and diastolic BP measured ≤24 h of stroke onset were independent predictors of good functional outcome (Rankin grades 1 and 2), whereas BP change was not. The survivors in the nimodipine arm with mild to moderately severe stroke had higher initial BP than the deceased ones, in severe strokes the situation was the opposite. Conclusions –

Stroke severity, visible cerebral infarcts on CT, and early commencement of nimodipine treatment were associated. Overall, high initial systolic and diastolic BP predicted a good functional outcome in patients on nimodipine. In severe strokes, the combination of nimodipine and high initial BP was associated with increased risk of death.

Keywords: acute ischemic stroke; blood pressure; nimodipine; stroke outcome

Document Type: Research Article

DOI: http://dx.doi.org/10.1034/j.1600-0404.2003.00202.x

Affiliations: 1: Department of Neurology, University Hospital, Helsinki, Finland 2: Tampere University Hospital, Tampere, Finland 3: Central Hospital of Central Finland, Jyväskylä, Finland

Publication date: March 1, 2004

Related content

Tools

Favourites

Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more