ABSTRACT
Objective To investigate the correlation betw een visit-to-visit blood pressure variability and long-term stroke recurrence in patients w ith ischemic stroke. Methods Consecutive patients w ith first-ever acute ischemic stroke w ere registered. The demographic and clinical data w ere documented. The patients w ere follow ed up every month after discharge. Visit-to-visit blood pressure w as measured, and its mean value and blood pressure variability parameters w ere calculated.A 12-month follow-up period w as completed and the recurrent stroke events w ere documented.Univariate analysis w as used to compare the demographic and clinical data in the recurrent and non-recurrent groups.Multivariate logistic regression analysis w as used to identify the correlation betw een visit-to-visit blood pressure variability and stroke recurrence. Results A total of 556 patients completed the follow-up, including 62 (11.2%) w ith recurrent stroke. The standard deviation (16.5 ±4.7 mmHg vs.13.4 ±4.2 mmHg, 1 mmHg=0.133 kPa; t=1.953, P=0.042) and coefficient of variation (11.9 ±3.1 vs.9.8 ±2.4; t=2.287, P=0.001) of visit-to-visit systolic blood pressure in the recurrent group w ere significantly higher than those in the non-recurrent group.Multivariable logistic regression analysis show ed that visit-to-visit coefficient of variation of systolic pressure w as independently associated w ith stroke recurrence (odds ratio 1.305,95% confidence interval 1.004-7.491;P=0.017). Conclusion The visit-to-visit blood pressure variability w as independently associated w ith long-term stroke recurrence in patients w ith acute ischemic stroke.
ABSTRACT
Objective To investigate the correlation betw een the short-term blood pressure variability and the recent outcome in patients w ith noncardioembolic ischemic stroke. Methods The patients w ith acute noncardioembolic ischemic stroke admitted to hospital betw een January 1, 2013 to June31, 2015 w ere enrol ed consecutively. The demographic and clinical data w ere col ected, and 24 h ambulatory blood pressure monitoring w as performed and each blood pressure variability parameter w as calculated. The modified Rankin scale (mRS) w as used to evaluate recent neurological outcome at the time of discharge or the fourteenth day in hospital. The mRS score 0-2 w as defined as good outcome, and >2 w as defined as poor outcome. Multivariate logistic regression analysis w as used to determine the correlation betw een the blood pressure and the short-term blood pressure variability indicators and recent neurological outcome. Results A total of 229 patients w ith acute noncardioembolic ischemic stroke w ere enrol ed, and 40.2% of them had recent poor functional outcome. The mean systolic pressure ( 147.8 ±19.6 mmHg vs.137.7 ± 19.1 mmHg; t=3.868, P<0.001; 1 mmHg=0.133 kPa) and the actual variation value of the mean systolic pressure (median, interquartile 11.7 [10.0-14.0] mmHg vs.10.6 [8.2-12.5] mmHg;Z=3.544, P<0.001) of the recent poor outcome group w ere significantly higher than those of the good functional outcome group. Multivariate logistic regression analysis show ed that after adjusting other confounders, the increased mean systolic pressure ( each 10 mmHg increase: odds ratio 1.189, 95% confidence interval 1.013-1.369; P=0.034) and the enlarged actual variation of systolic blood pressure (each 1 mmHg increase:odds ratio 1.182, 95% confidence interval 1.046-1.336; P=0.008) w ere associated w ith the recent poor functional outcome. Conclusions The increased short-term blood pressure variability w as associated w ith the recent poor functional outcome in patients w ith acute noncardioembolic ischemic stroke.
ABSTRACT
Objective To explore the relationship between 24-hour blood pressure variability after admission and early neurological deterioration in patients with acute non-cardioembolic ischemic stroke.Methods This was a case-control study.Patients with acute non-cardioembolic ischemic stroke within 72 hours after stroke onset were prospectively registered.Clinical and 24 -hour continuous blood pressure monitoring data were recorded, and subsequently compared with regard to whether early neurological deterioration ( END) occurred within 7 days after admission.Factors contributing to END were investigated by logistic regression model.Results Of 221 eligible patients, 59 cases ( 26.7%) exhabited END.Patients with END had higher 24-hour mean systolic blood pressure ( SBP) (145.8 ±18.2 mmHg vs.139.9 ± 20.3 mmHg, P=0.014) and SBP coefficient of deviation (SBP-CV) [9.0(7.3 -11.2) vs.8.4(6.9-10.2), P=0.011].After adjusting for crude variables, multivariate analysis showed that the increase in mean SBP (10 mmHg mean SBP,OR=1.285,95%CI(1.059~1.559) and SBP-CV [1 unit of SBP-CV, OR=1.206,95%CI(1.050~1.384)] was associated with higher risk of END.Conclusions Increased 24-hour blood pressure variability after admission is an independent risk factor for occurrence of END in patients with acute non-cardioembolic ischemic stroke.