Correlation between the short-term blood pressure variability and the recent outcome in patients with noncardioembolic ischemic stroke

Abstract

Objective To investigate the correlation between the short-term blood pressure variability and the recent outcome in patients with noncardioembolic ischemic stroke. Methods The patients with acute noncardioembolic ischemic stroke admitted to hospital between January 1, 2013 to June31, 2015 were enrolled consecutively. The demographic and clinical data were collected, and 24 h ambulatory blood pressure monitoring was performed and each blood pressure variability parameter was calculated. The modified Rankin scale (mRS) was used to evaluate recent neurological outcome at the time of discharge or the fourteenth day in hospital. The mRS score 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the correlation between the blood pressure and the short-term blood pressure variability indicators and recent neurological outcome. Results A total of 229 patients with acute noncardioembolic ischemic stroke were enrolled, 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 were significantly higher than those of the good functional outcome group. Multivariate logistic regression analysis showed 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) were associated with the recent poor functional outcome. Conclusions The increased short-term blood pressure variability was associated with the recent poor functional outcome in patients with acute noncardioembolic ischemic stroke. Key words: Stroke; Brain Ischemia; Blood Pressure; Prognosis; Risk Factors