Document Detail

Hypertension and daytime hypotension found on ambulatory blood pressure is associated with fatigue following stroke and TIA.
MedLine Citation:
PMID:  19033353     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fatigue affects up to 68% of subjects following stroke. In non-stroke patients, associations are reported between chronic fatigue and both hypertension and hypotension. We hypothesized that, in patients with stroke or transient ischaemic attack (TIA), an association may exist between fatigue and abnormal blood pressure (BP) detected on ambulatory monitoring. METHODS: Subjects recruited from a secondary prevention clinic underwent 24-h ambulatory BP monitoring and completed a questionnaire including the Fatigue Severity Scale (FSS). RESULTS: One hundred subjects were included (51% female, mean age 69 years). Mean FSS was 3.6 and 42 has a FSS >4 indicative of significant fatigue. Mean daytime BP for all subjects was 134/74 (SD 16/11 mmHg). There was no significant difference in mean BP between patients with and those without significant fatigue. Patients with stroke suffered worse fatigue than those with TIA (mean FSS 3.8 vs. 3.0, P = 0.03). Twenty-four subjects were hypertensive (mean 24-h BP >145/90 mmHg), 26 had a lowest daytime diastolic BP (DBP) <50 mmHg and 4 had both. Fifty-four subjects were normotensive and these had a significantly lower mean FSS than either those with hypertension (mean FSS 3.2 vs. 4.2, P = 0.02, t-test) or those with low DBP (mean FSS 3.2 vs. 4.2, P = 0.01, t-test). Hypertensive subjects were more likely to be significantly fatigued [chi(2) 3.8, P = 0.05, OR 3.1 (1.1-8.3)] as were subjects with low daytime DBP [chi(2) 8.4, P = 0.004, OR 4.2 (1.5-11.1)]. CONCLUSION: In subjects who have suffered a stroke or TIA, fatigue is associated with measures of both hypertension and hypotension on ambulatory monitoring. Patients with stroke suffered worse fatigue than those with TIA.
J A Harbison; S Walsh; R A Kenny
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-25
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  102     ISSN:  1460-2393     ISO Abbreviation:  QJM     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-22     Completed Date:  2009-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  England    
Other Details:
Languages:  eng     Pagination:  109-15     Citation Subset:  IM    
Department of Medical Gerontology, Trinity College Dublin, Ireland.
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MeSH Terms
Aged, 80 and over
Blood Pressure / physiology
Blood Pressure Monitoring, Ambulatory
Depressive Disorder / diagnosis
Fatigue / etiology*
Hypertension / etiology*
Hypotension / etiology*
Ischemic Attack, Transient / complications*,  physiopathology
Middle Aged
Risk Factors
Severity of Illness Index
Stroke / complications*,  physiopathology

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