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Both high and low blood pressure during the acute phase of ischemic stroke are associated with brain injury and poor outcome, new research indicates. A study published in Stroke examined the relationship of systolic and diastolic BP during the first 24 hours of ischemic stroke with outcome in 258 patients.

For every 10 mm drop below 180 mm Hg of systolic BP, the risk of early neurological deterioration rose by 6%.

For poor outcome, the corresponding increase was 25%. For mortality at three months, it was 7%. Mean infarct volume also increased by 7.3 cubic centimeters.

For every 10 mm increase beyond 180 mm Hg, the risk of early neurological deterioration increased by 40% and that of poor outcome increased by 23%.

The researchers also found a similar pattern for diastolic blood pressure of 100 mm Hg or lower or of greater than 100 mm Hg.

The authors conclude that a fall of more than 20 mm Hg in systolic BP was 'the most important variable associated with early neurological deterioration, poor outcome and large infarct volumes.'