Hypertension before and after posterior circulation infarction: analysis of data from the South London Stroke Register

Matthew Cates, Julian Paton, N.C. Smeeton, Charles Wolfe

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10 Citations (Scopus)


Background: Postmortem data have shown that blood pressure before death correlates more closely with a narrowing of the vertebral arteries than any other vessel studied. This study explores a possible association between hypertension, both before and after posterior circulation infarction (POCI) compared to anterior circulation infarction (ACI).
Methods: Patients with a first-ever stroke enrolled in the South London Stroke Register between 2000 and 2006 were included. Chi-square tests and multivariable logistic regression were used to compare risk factors including hypertension, sex, smoking history, diabetes, and hypercholesterolemia in patients with POCI compared to ACI. Chi-square testing was used to compare the incidence of newly diagnosed hypertension after POCI and ACI. Absolute blood pressure readings recorded before stroke and 7 days after stroke were also compared between groups.
Results: On multivariable analysis, POCI was significantly associated with male sex (odds ratio [OR] 2.24; 95% confidence interval [CI] 1.55-3.22; P < .001) and hypertension (OR 1.69; 95% CI 1.15-2.50; P = .008). After stroke, patients with POCI were more likely to be newly diagnosed with hypertension during a 1-year follow-up period (OR 2.15; 95% CI 1.20-3.86; P = .009) and as an inpatient (OR 3.27; 95% CI 1.49-7.13; P = .002). Systolic blood pressure was significantly higher in the POCI group before stroke (152 v 146 mm Hg; P = .027). Diastolic blood pressure was significantly higher 7 days poststroke (81 v 74 mm Hg; P = .01) in patients not previously diagnosed with hypertension.
Conclusions: This study has shown a significant association between hypertension before and after POCI compared to ACI. We believe further investigation with brainstem imaging and recordings of sympathetic nervous system activity after stroke is warranted.
Original languageEnglish
Pages (from-to)612-618
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number7
Publication statusPublished - 2012


  • hypertension
  • posterior circulation infarction
  • stroke
  • vertebrobasilar ischemia


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