02395nas a2200289   4500000000100000008004100001100007900042700001900121700001700140700001700157700001700174700001400191700001700205700001600222700001000238700001200248700001400260700001800274700001400292700001800306700001600324245010600340300001000446490000800456520162700464022001402091       2017                            d1 aChinaQUEST (Quality Evaluation of Stroke Care and Treatment) Investigators1 aAnderson Craig1 aHuang Yining1 aWang Jiguang1 aLiu Yuanyuan1 aYang Yide1 aJin Haiqiang1 aFan Chenghe1 aLv Pu1 aSun Wei1 aPeng Qing1 aZhao Mingming1 aJin David1 aWong Lawrence1 aZheng Lemin00aDiscrepant relationships between admission blood pressure and mortality in different stroke subtypes.  a47-510 v3833 a<p>The relationship between blood pressure(BP) and clinical outcome in patients with acute stroke is still controversial. The present study aimed to elucidate the impact of admission blood pressure on mortality in patients with acute stroke of different subtypes. Data were from ChinaQUEST (QUality Evaluation of Stroke Care and Treatment), a multicenter, prospective hospital registry study in 37 cities across China. A total of 6427 patients were admitted within 24h of onset and after following up for 12months, 5501 were included in the final analysis. Multivariate Cox regression model were used in data analysis. A "U-curve shaped" relationship was observed between admission systolic or diastolic BP and mortality at 12months in the overall study population. Compared to first quartile, the Hazard ratio (HR) for the systolic BP of top quartile was 1.444 (95%CI 1.854-1.636), while the HR was 0.692 (95%CI 0.802-0.930) for the second quartile. Similar associations were observed when we applied admission diastolic BP. In subgroup analysis, the U-shaped effect was remained only in patients with intracranial hemorrhage (ICH). The HR for the systolic BP of top quartile was 2.274 (95%CI 1.878-2.755), while the HR was 0.751 (95%CI 0.571-0.986) for the second quartile. Moreover, admission diastolic BP of top quartile was significantly associated with elevated risk of death for patients with ischemic stroke caused by small vessel diseases (LACI)(HR 1.470; CI 1.040-2.078). In addition, we found a heterogeneity of the admission BP distribution among different subtypes, which may explain the "U-curve" effect.</p>  a1878-5883