Visit-to-visit blood pressure variability predicts long-term stroke recurrence in patients with ischemic stroke: a prospective case series study

Abstract

Objective To investigate the correlation between visit-to-visit blood pressure variability and long-term stroke recurrence in patients with ischemic stroke. Methods Consecutive patients with first-ever acute ischemic stroke were registered. The demographic and clinical data were documented. The patients were followed up every month after discharge. Visit-to-visit blood pressure was measured, and its mean value and blood pressure variability parameters were calculated. A 12-month follow-up period was completed and the recurrent stroke events were documented. Univariate analysis was used to compare the demographic and clinical data in the recurrent and non-recurrent groups. Multivariate logistic regression analysis was used to identify the correlation between visit-to-visit blood pressure variability and stroke recurrence. Results A total of 556 patients completed the follow-up, including 62 (11.2%) with 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 were significantly higher than those in the non-recurrent group. Multivariable logistic regression analysis showed that visit-to-visit coefficient of variation of systolic pressure was independently associated with stroke recurrence (odds ratio 1.305, 95% confidence interval 1.004-7.491; P=0.017). Conclusion The visit-to-visit blood pressure variability was independently associated with long-term stroke recurrence in patients with acute ischemic stroke. Key words: Stroke; Brain Ischemia; Hypertension; Blood Pressure; Recurrence; Risk Factors; Time Factors