Smotrytska T. Acute cerebral stroke: variability of blood pressure in the structure of other predictors of course and outcomes

The dissertation presents a new solution to the scientific problem of influencing the course of the acute stroke period, its direct and long-term consequences of change and variability of blood pressure in the acute stroke period. New scientific confirmations of the prognostic impact of a number of clinical and demographic factors on the effects of stroke have been obtained, as well as the reliable influence and significant prognostic value of indicators of blood pressure variability, especially in the early acute period, on the degree of recovery of neurologic deficits and function. The influence of various clinical and demographic factors on the risks of complicated stroke in acute, hospital period, as well as on the negative evaluation of immediate (21 days after the onset of symptoms) and long-term effects (90 days after the onset of symptoms) of stroke is established. It was noted that in the first 72 hours of hospital observation, all parameters of blood pressure in acute stroke, including average, maximum values, swings and coefficients of variability, were significantly higher than in the subsequent hospital stay; a positive assessment of the long-term effects of stroke was significantly associated with lower blood pressure in the first 72 hours in both the mixed group and the ischemic stroke group. It is determined that the prognostic significance of the indicators declines during the observation period after 72 hours, especially for diastolic pressure. The dependence of nominal blood pressure and stroke outcomes persists for both patients undergoing traditional therapy (except for the influence of the diastolic pressure values) and for patients undergoing thrombolytic treatment (with greater accuracy during the first 72 hours). Concerning hemorrhagic stroke, the prognostic effect of blood pressure indicators on the long-term result could not be established.