Our results also suggest that prehospital SBP measurements in the patient with impaired conscious level might be a helpful guide as to where to transport a patient especially in communities that have both comprehensive stroke centers and primary ischemic stroke centers. This study showed that the risk of stroke occurrence among emergency patients with impaired consciousness increased with increasing prehospital SBP. A previous study showed that initial SBP at emergency department arrival was of help for diagnosing intracranial lesion of patients with impaired consciousness

[9]. However, diagnosis after hospital arrival is too late Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical to transport the stroke patient to www.selleckchem.com/products/17-AAG(Geldanamycin).html appropriate institution and start treatments against stroke in the effective time window [10]. Guidelines for the Early Management of Adults With Ischemic Stroke by American Heart Association recommend quicker transportation of suspected stroke patients to stroke care

units to improve better neurological outcome [11]. Importantly, paralysis of stroke patients is frequently difficult to evaluate Inhibitors,research,lifescience,medical when their consciousness is disturbed. Therefore, this study showing the association sellectchem between prehospital SBP measurements and stroke occurrence among patients with impaired consciousness would contribute to earlier Inhibitors,research,lifescience,medical detection of stroke and subsequent rapid transport to appropriate hospitals that can conduct specific treatments for them. In analyses by stroke

subtype, increased SBP was more strongly associated with Inhibitors,research,lifescience,medical occurrence of stroke among patients with hemorrhagic brain lesions such as SAH and ICH. The mechanism of hypertensive response among stroke patients is unclear [12] although patients with acute stroke and those with increased intracranial pressure often have hypertension. It was reported that 84% of patients with stroke had increased blood pressure Batimastat in the acute phase [13]. The arterial pressure elevation in response to cerebral ischemia is known as the central nervous system ischemic response [14]. In ischemic stroke, hypertension maybe adaptive response to improve perfusion to the ischemic penumbra protecting the brain from further ischemia. On the other hand, hypertension in hemorrhagic brain lesion like SAH or ICH may cause further damage by worsening cerebral edema, increasing intracranial pressure, or causing hematoma expansion [15,16]. Our result showing difference by the subtype of stroke might be partially explained by such pathophysiological differences between hemorrhagic and ischemic lesions.