OBJECTIVES Stroke, the most common neurologic disorder and the major cause of disability and death after heart disease causing 11.8% of the total deaths worldwide, is defined as a rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 h. This study aims to assess appropriateness of hypertension treatment in acute stroke and its adherence with the choice of medications tailored according to blood pressure readings. PATIENTS AND METHODS This was a pilot study performed in Lebanese hospitals where medical records of ischemic stroke patients were used to collect required data. The study enrolled ischemic stroke patients older than 18 years of age, admitted to intensive care unit or internal medicine department. Patients with hemorrhagic stroke were excluded. Statistical analysis was done using IBM Statistical Package for the Social Science software. The significance level is p-value ≤ 0.05. RESULTS A total of 146 patients (56.8% females; mean age 76.6 ± 11.9) were included in the analysis. At baseline, patients had a mean ± standard deviation (SD) SBP of 160.6 (±31.3) and a mean DBP of 85.5. Labetalol and amlodipine were administered to patients with significantly higher baseline blood pressure (p < 0.001). Change in SBP from baseline after 2 h of drug administration was significantly higher with labetalol (p = 0.028 for patients eligible for reperfusion), amlodipine (p = 0.014), and nitroglycerine (p = 0.044). As for the change in SBP after 24 h, it was significantly higher with labetalol just for patients not eligible for reperfusion (p < 0.001), and amlodipine (p = 0.006). As for the change in DBP, it was significantly lower after 24 h on labetalol administration for patients not eligible for reperfusion (p < 0.001) and it was also lower 2 h after administration of ramipril (p = 0.001) and 24 h (p = 0.021). CONCLUSION This study reveals the gap between American Stroke Association guideline recommendations and the clinical practice and states the impact of such a difference on patients' health.

中文翻译：

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12缺血性脑卒中患者高血压急性期治疗评估

目的 中风是最常见的神经系统疾病，也是心脏病后致残和死亡的主要原因，占全球总死亡人数的 11.8%，被定义为持续超过 24 小时的脑功能局灶性障碍的快速发展的临床体征。本研究旨在评估急性卒中高血压治疗的适当性及其依从性，根据血压读数选择合适的药物。患者和方法 这是一项在黎巴嫩医院进行的试点研究，其中缺血性中风患者的医疗记录用于收集所需数据。该研究招募了 18 岁以上、入住重症监护室或内科的缺血性卒中患者。排除出血性卒中患者。使用 IBM Statistical Package for the Social Science 软件进行统计分析。显着性水平是 p 值 ≤ 0.05。结果 共有 146 名患者（56.8% 女性；平均年龄 76.6 ± 11.9）被纳入分析。在基线时，患者的平均 ± 标准差 (SD) SBP 为 160.6 (±31.3)，平均 DBP 为 85.5。将拉贝洛尔和氨氯地平用于基线血压显着升高的患者（p < 0.001）。使用拉贝洛尔（对于符合再灌注条件的患者，p = 0.028）、氨氯地平（p = 0.014）和硝酸甘油（p = 0.044），给药 2 小时后 SBP 相对于基线的变化显着更高。至于 24 小时后 SBP 的变化，拉贝洛尔仅对不适合再灌注的患者（p < 0.001）和氨氯地平（p = 0.006）显着更高。至于 DBP 的变化，对于不符合再灌注条件的患者，在使用拉贝洛尔 24 小时后显着降低（p < 0.001），并且在使用雷米普利后 2 小时（p = 0.001）和 24 小时（p = 0.021）。结论 本研究揭示了美国卒中协会指南建议与临床实践之间的差距，并说明了这种差异对患者健康的影响。