Deans' stroke musings: Early morning blood pressure, pulse wave velocity, central aortic pressure and predictive risk factors of ischemic stroke in masked hypertensive patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, October 29, 2016

Early morning blood pressure, pulse wave velocity, central aortic pressure and predictive risk factors of ischemic stroke in masked hypertensive patients

Bet this never makes it to your hospital or is even written up as a stroke protocol.
https://www.mdlinx.com/internal-medicine/medical-news-article/2016/10/27/hypertensive-patients-stroke-morning-blood-pressure/6899897/?news_id=881&newsdt=102916&subspec_id=488&

JACC - Journal of the American College of Cardiology, 10/27/2016

Koh JH, et al. – This study intended to assess the prevalence of masked early morning or nocturnal hypertension (NHT) and effects of arterial stiffness, pulse wave velocity(PWV) and wave reflections on central aortic pressure (CAP) in hypertensive patients with ischemic stroke(IS). The study proposes that higher prevalence of masked early morning hypertension(EMHT) and a significant increase of early morning BP, particular systolic BP, may be predictive risk factor for ischemic stroke events instead than nocturnal BP. So, ASP measurements may be especially important for the early detection of ischemic stroke event.

Methods

Using 24hr ambulatory blood pressure monitoring (ABPM), the researchers analyzed a total 450 hypertensive patients with IS, investigate masked hypertension(MHT) .
Classified as masked EMHT (early morning BP ≥ 135/85 mmHg and night-time BP ≤ 120/70 mmHg), Masked NHT(Daytime BP ≤ 135/85 mmHg and night-time BP ≥120/70 mmHg) among the MHT.
And using radial artery applanation tonometry, aortic pulse analysis was performed in MHT.

Results

The researchers observed MHT with ischemic stroke in 128 patients.
The study found EMHT in 55.6% of MHT patients (n=71).
EMHT had higher aortic pulse wave velocity(PWV) and augmentation index(AI) and AI75 (AI to HR 75 beat/min), ASP (Central aortic systolic pressure) and pulse pressure were also higher in the EMHT as compared with patients with both EMHT and NHT.

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