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I have with great interest read the article "Hypertension in Acute Ischemic Stroke" by Semplicini et al.¹ Their results corroborate my and my colleagues' earlier results² based on 1192 patients. We found that blood pressure decreased in mild to moderate stroke but not in severe stroke and that the blood pressure decrease was related to the time of admission and not to the delay from symptom onset, as it has also previously been demonstrated.³ The blood pressure reported by Semplicini et al¹ reflects that the patients had in reality 2 admissions, one in the emergency department and one in the admission department. Blood pressure is highly influenced by changes in environment. If the patient remains in the same department, blood pressure decreases within 8 hours.

Semplicini et al¹ concluded that "lacunar stroke and the highest admission blood pressure carry the best prognosis," defining lacunar stroke according to the clinical definitions . . . [Full Text of this Article]

Hanne Christensen, MD, PhD
Copenhagen, Denmark

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