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Abstract
Objective: To determine the prevalence of hypertension (HPT) in the acute phase after ischemic stroke (IS) and explore its relationship to outcome.
Methods: We performed a retrospective review of children aged 1 month to 18 years with first IS admitted to a tertiary hospital between 2003 and 2008. Blood pressure readings recorded over the first 72 hours after diagnosis and morbidity or mortality at 12 months were documented. HPT was defined as 2 consecutive readings of systolic blood pressure ≥95th percentile for age.
Results: Ninety children were identified (median age 3.8 years). Fifty-three of 84 patients (63%) who had blood pressure readings available had at least 1 episode of HPT and 19 (22%) had HPT on 3 consecutive days. HPT was more prevalent at both ends of the age spectrum. The relative risk of 12-month mortality was 4.5 times higher (95% confidence interval = 0.6–34.5, p = 0.096) and relative risk of death in the hospital was 1.7 times higher (95% confidence interval = 1.4–2.0, p = 0.05) if the patient experienced HPT. There was no association between HPT and vascular territory, etiology, or neurologic disability.
Conclusions: HPT is prevalent in children with IS in the first 3 days after diagnosis and is associated with increased risk of death. Larger prospective studies involving systematic recording of blood pressure are required to delineate the impact of HPT on risk of death or disability.
GLOSSARY
- BP=
- blood pressure;
- CI=
- confidence interval;
- GMFCS=
- Gross Motor Function Classification System;
- HPT=
- hypertension;
- ICD-10=
- International Classification of Diseases and Related Health Problems, 10th revision;
- IS=
- ischemic stroke;
- KOSCHI=
- King’s Outcome Scale for Childhood Head Injury;
- MACS=
- Manual Ability Classification System;
- RCH=
- Royal Children's Hospital
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received May 16, 2012.
- Accepted December 26, 2012.
- © 2013 American Academy of Neurology
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