Objective      To explore the effect of blood pressure on the cerebral and renal perfusion of patients in early stage of ischemic stroke

and find an optimal blood pressure management method.       Methods      In the study

873 patients with first onset of cerebral infarction within 24 h were selected

and divided into an intravenous antihypertensive group

an oral antihypertensive group and an observation group based on the blood pressure at admission. The blood pressure values were divided into 7 levels. The blood pressure at 3

6

12

and 24 h after cerebral infarction onset was dynamically monitored

and the glomerular filtration rate (GFR) and internal carotid artery flow (ICAF) were synchronously detected. The correlation of blood pressure levels and probability of perfusion outcomes (good perfusion

inadequate perfusion and perfusion recession) was analyzed using univariate and multivariate COX proportional hazard analysis.       Results      The blood pressure at admission in the intravenous antihypertensive group was (184.5±23.6) mmHg/(123.7±15.4) mmHg

significantly higher than (167.3±18.5) mmHg/(112.1±14.2) mmHg in the oral antihypertensive group (P0.05). After the same administration time

the blood pressure level of the intravenous antihypertensive group decreased to (143.2±13.7) mmHg/(93.6±10.2) mmHg

significantly lower than (153.7±12.8) mmHg /(106.3±11.6) mmHg of the oral antihypertensive group (P0.01). The probability of good perfusion was the highest and the risk of inadequate perfusion and perfusion recession was lowest in the group with systolic blood pressure (SBP) 140-159 mmHg and diastolic blood pressure (DBP) 90-99 mmHg. However

the probability of good perfusion was the lowest and the risk of inadequate perfusion and perfusion recession was highest in the group with SBP ≥180 mmHg and DBP ≥110 mmHg. The results were the same even if potential confounding factors were removed. Based on the C-statistics

the odds ratios of SBP and DBP were 0.571 and 0.574

respectively

at good neurological recovery

1.541 and 1.678 at neurological deterioration

and 1.523 and 1.556 at poor functional outcome.       Conclusion      The blood pressure level in early stage of ischemic stroke is closely correlated with cerebral and renal perfusion. Maintaining blood pressure at the mild hypertension level (140-159/90-99 mmHg) to provide intravenous antihypertensive therapy within 24 hours will be helpful to the cerebral and renal perfusion for the patients with blood pressure ≥180/110 mmHg at admission.