The severity of the neurological deficit assessed by the NIHSS at admission was 9.5±0.35 points; 57.4 % of the patients had a moderate neurological deficit. The mean duration of hypertension in patients was 12.3±0.64 years. Almost half of the patients had stage 2 hypertension - 72 (48,0 %), about one third - 48 (32 %) of the patients had stage 3 hypertension, and 30 (20 %) - stage 1 hypertension.
A direct significant correlation was established between the stage of the hypertension, its duration, the mean values of the mean SBP and DBP, their variability, and the severity of the neurological deficit; they significantly correlated with the outcomes of acute and recovery periods of ischemic stroke in patients with stroke associated with primary hypertension.
A significant correlation was established between the stage of hypertension and the size of ischemia. It was found that stroke severity on the 21st day and the degree of functional recovery significantly correlate with the variability of SBP in the period from the 1st to the 6th day.
It was observed that the severity of cognitive impairment on the 21st day of stroke is related to the stage and the duration of hypertension, the variability of SBP in the hyperacute period of stroke cases of severe and moderate ischemic stroke, bilateral stenosis, and the increase of IMT of more than 1.17 mm. The correlation between these indicators remains one year later. It was demonstrated that the state of cognitive functions in the acute period affects the functional recovery at the 21st day and one year after the ischemic stroke. Further, those 31.5 % of patients that had a decrease in MMSE score one year after stroke showed significantly higher mean values of SD determined during
1-6 days and the SBP level at 1st day than those patients without the deterioration of the cognitive function.
The developed mathematical model (sensitivity – 93,9 %, specificity – 86,5 %, and diagnostic accuracy – 90,1 %) defined the following independent predictors of minimal functional restriction (which is predicted with a probability of more than 50 %) in the acute period of moderate and severe ischemic stroke: the variability of SBP in the first three days is less than 17.6 mm Hg, the variability of DBP in the first three days is less than 8.7 mm Hg, and the score for ММSЕ ≥25 at 14 day. These findings indicate the feasibility of reducing the variability of SBP and DBP in the first 3-6 days and of taking measures to improve the cognitive status within 2 weeks after stroke.
The developed mathematical model (sensitivity – 95,3 %, specificity – 88,9 %, diagnostic accuracy – 93,4 %) defined the following independent predictors of minimal functional restriction (which is predicted with a probability of more than 50 %) 1 year after the moderate and severe ischemic stroke: the score for MMSE ≥ 21, IMT < 1.17 mm, achievement of target values for blood pressure during the first 6 months after stroke, and the use of ARBs II in combination with calcium antagonists or in monotherapy. These findings indicate the need to achieve target blood pressure in the early recovery period (especially with ARBs II and calcium antagonists in case of stages 2 and 3 hypertension), to stabilize of atherosclerotic process (particularly with the use of statins), and to intensively improve the cognitive status.
