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The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST)

Sare, Gillian M.; Bath, Philip M.W.; Gray, Laura J.; Moulin, Thierry; Woimant, France; England, Timothy; Geeganage, Chamila; Christensen, Hanne; De Deyn, Peter Paul; Leys, Didier; O'Neill, Desmond; Ringelstein, Bernd

Authors

Gillian M. Sare

Philip M.W. Bath

Laura J. Gray

Thierry Moulin

France Woimant

Timothy England

Chamila Geeganage

Hanne Christensen

Peter Paul De Deyn

Didier Leys

Desmond O'Neill

Bernd Ringelstein



Abstract

Background and Purpose—High blood pressure (BP) is present in 80% of patients with acute ischemic stroke and is
independently associated with poor outcome. There are few data examining the relationship between admission BP and
acute CT findings.
Methods—TAIST was a randomized controlled trial assessing 10 days of treatment with tinzaparin versus aspirin in 1489
patients with acute ischemic stroke (48 hr) with admission BP of 220/120 mm Hg. CT brain scans were performed before randomization and after 10 days. The relationships between baseline BP and adjudicated CT findings were assessed. Odds ratios per 10 mm Hg change in BP were calculated.
Results—Higher systolic BP (SBP) was associated with abnormal CT scans because of independent associations with
chronic changes of leukoariosis (OR, 1.12; 95% CI, 1.05–1.17) and old infarction (OR, 1.12; 95% CI, 1.06 –1.17) at
baseline, and signs of visible infarction at day 10 (OR, 1.06; 95% CI, 1.00 –1.13). A lower SBP was associated with
signs of acute infarction (OR, 0.94; 95% CI, 0.89–0.99). Hemorrhagic transformation, dense middle cerebral artery
sign, mass effect, and cerebral edema at day 10 were not independently associated with baseline BP.
Conclusion—Although high baseline BP is independently associated with a poor outcome after stroke, this was not shown to be through an association with increased hemorrhagic transformation, cerebral edema, or mass effect; trial design may be suboptimal to detect this. Higher SBP is associated with visible infarction on day 10 scans. The influence of changing BP in acute stroke on CT findings is still to be ascertained.

Journal Article Type Article
Publication Date Jan 1, 2009
Journal Stroke
Print ISSN 0039-2499
Electronic ISSN 0039-2499
Publisher American Heart Association
Peer Reviewed Peer Reviewed
Volume 40
Issue 1
APA6 Citation Sare, G. M., Bath, P. M., Gray, L. J., Moulin, T., Woimant, F., England, T., …Ringelstein, B. (2009). The relationship between baseline blood pressure and computed tomography findings in acute stroke: data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST). Stroke, 40(1), doi:10.1161/STROKEAHA.108.526665
DOI https://doi.org/10.1161/STROKEAHA.108.526665
Publisher URL http://stroke.ahajournals.org/cgi/reprint/40/1/41?cookietest=yes
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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