Short-Term Blood Pressure Variability in Acute Stroke

The optimal range of blood pressure variability (BPV) for acute stroke patients with large-vessel occlusion (LVO) remains unclear. This study investigated the association between BPV from admission through the first 24 h after intra-arterial thrombectomy (IAT) and short-term outcome in LVO patients. We retrospectively analyzed 257 consecutive patients with LVO stroke who were treated with IAT. BP values were recorded at 2-h intervals from admission through the first 24 h after IAT. BPV, as reflected by pulse pressure variability (PPV), was determined based on standard deviation (SD), coefficient of variation (CV), successive variation (SV), and the difference between maximum and minimum blood pressure (ΔBP; systolic BP minus diastolic BP). The association between BPV and clinical outcome (Modified Rankin Scale score at 90 days) was analyzed by multivariate logistic regression analysis. Of the 257 included patients, 70 had a good outcome at 3 months. PPV from admission through the first 24 h after IAT was independently associated in a graded manner with poor outcome [multivariable-adjusted odds ratios (95% confidence interval) for the highest of PPV were 43.0 (8.7–212.8) for SD, 40.3 (9.8–165.0) for CV, 55.0 (11.2–271.2) for SV, and 40.1 (8.0–201.9) for ΔBP]. The area under the receiver operating characteristic curve (95% confidence interval) of the PPV parameters were 0.924 (0.882–0.965) for SD, 0.886 (0.835–0.938) for CV, 0.932 (0.891–0.973) for SV, and 0.892 (0.845–0.939) for ΔBP, and the Youden index values were 0.740, 0.633, 0.759, and 0.756, respectively. In summary, BPV from admission through the first 24 h after IAT was independently associated with poor outcome at 3 months in patients with LVO, with greater variability corresponding to a stronger association. Thus, PPV may be a clinically useful predictor of functional prognosis in LVO patients treated with IAT.

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Elevated levels of short-term blood pressure variability: A marker for ascending aortic dilatation in hypertensive patients

Clinical and Experimental Hypertension ◽

10.1080/10641963.2021.1871915 ◽

2021 ◽

pp. 1-9

Author(s):

Onur Argan ◽

Eyup Avci ◽

Serdar Bozyel ◽

Tarik Yildirim ◽

Ozgen Safak ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Aortic Dilatation ◽

Short Term ◽

Hypertensive Patients

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THE RELATIONSHIP BETWEEN EARLY BLOOD PRESSURE VARIABILITY AND SHORT-TERM PROGNOSIS IN SEVERE TRAUMATIC BRAIN INJURY PATIENTS

Heart ◽

10.1136/heartjnl-2012-302920r.15 ◽

2012 ◽

Vol 98 (Suppl 2) ◽

pp. E255.4-E256

Author(s):

Chen Hui ◽

Wu Xiaoying ◽

Chen Hui

Keyword(s):

Blood Pressure ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Blood Pressure Variability ◽

Short Term ◽

The Relationship

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Antihypertensive drug classes have different effects on short-term blood pressure variability in essential hypertension

Hypertension Research ◽

10.1038/hr.2014.33 ◽

2014 ◽

Vol 37 (6) ◽

pp. 585-590 ◽

Cited By ~ 34

Author(s):

Natacha Levi-Marpillat ◽

Isabelle Macquin-Mavier ◽

Anne-Isabelle Tropeano ◽

Gianfranco Parati ◽

Patrick Maison

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Antihypertensive Drug ◽

Blood Pressure Variability ◽

Short Term ◽

Drug Classes

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Short-term beat-to-beat but not ambulatory blood pressure variability is correlated to carotid intima-media thickness

Blood Pressure Monitoring ◽

10.1097/mbp.0000000000000062 ◽

2014 ◽

Vol 19 (5) ◽

pp. 288-293 ◽

Cited By ~ 8

Author(s):

Efstathios Manios ◽

Fotios Michas ◽

Kimon Stamatelopoulos ◽

Gerasimos Barlas ◽

Eleni Koroboki ◽

...

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Blood Pressure Variability ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Short Term ◽

Media Thickness

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Effects of 12 weeks of aerobic versus combined aerobic plus resistance exercise training on short-term blood pressure variability in patients with hypertension

Journal of Applied Physiology ◽

10.1152/japplphysiol.00910.2020 ◽

2021 ◽

Vol 130 (4) ◽

pp. 1085-1092

Author(s):

Giuseppe Caminiti ◽

Ferdinando Iellamo ◽

Annalisa Mancuso ◽

Anna Cerrito ◽

Matteo Montano ◽

...

Keyword(s):

Blood Pressure ◽

Exercise Training ◽

Resistance Exercise ◽

Aerobic Exercise ◽

Blood Pressure Variability ◽

Short Term ◽

Resistance Exercise Training ◽

Hypertensive Patients ◽

Combined Exercise ◽

Resistance Exercises

Combined exercise training (CT) including aerobic plus resistance exercises could be more effective in comparison with aerobic exercise (AT) alone in reducing blood pressure variability (BPV) in hypertensive patients. We report that CT was indeed more effective than AT in reducing short-term BPV, and both exercise modalities reduced BP levels to the same extent. CT appears to be a more appropriate exercise modality if the objective is to reduce BPV in addition to BP levels.

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Abstract P199: Higher Circulating Triglycerides are Independently Associated With Greater Short-term Blood Pressure Variability in Middle-aged/older Adults With Obesity

Hypertension ◽

10.1161/hyp.70.suppl_1.p199 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Rachel E Luehrs ◽

Graziela Z Kalil ◽

Seth W Holwerda ◽

Nealy A Wooldridge ◽

Jess G Fiedorowicz ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Blood Pressure Variability ◽

Plasma Lipids ◽

Target Organ Damage ◽

Density Lipoprotein ◽

Multiple Linear Regression Model ◽

Middle Aged ◽

Short Term ◽

Cvd Risk

Elevated short-term (24 hour) blood pressure variability (BPV) is associated with subclinical target organ damage and cardiovascular disease (CVD) among middle-aged/older (MA/O) adults with hypertension and obesity. Circulating total cholesterol (TC), low-density cholesterol (LDL-C) and triglycerides (TGs) increase with human obesity and are independent risk factors for CVD. In addition, BPV is increased in mouse models of hyperlipidemia and is normalized with statins. However, whether higher circulating lipoproteins independently contribute to greater short-term BPV among adults with obesity remains unclear. We hypothesized that higher LDL-C, TGs and lower high-density lipoprotein (HDL-C) would be associated with greater short-term BPV among individuals with obesity. Fasting plasma lipids and 24 hour ambulatory BP monitoring were assessed in fifty-six MA/O adults with obesity defined as body mass index (BMI) ≥ 30 kg/m 2 (56% F; age 54±7 yrs; BMI, 38.2±5.6 kg/m 2 ) and at least one other CVD risk factor. There was a significant relation between 24 hour systolic BPV and TC (r=0.30, P=0.03), TGs (r=0.34, P=0.01) and LDL-C (r=0.25, P=0.059), but not HDL-C (r=-0.07, P=0.61). Interestingly, these findings remained significant after adjusting for age, sex, BMI and 24 hour systolic BP (TC: r=0.34, P=0.01; TGs: r=0.39, P<0.01; LDL-C: r=0.31, P=0.03) but HDL-C remained non-significant (r=-0.16, P=0.27). In contrast, other cardiometabolic risk factors such as fasting glucose, insulin, c-reactive protein concentrations, carotid-femoral pulse wave velocity and HOMA-IR were not associated with 24 hour systolic BPV. In a multiple linear regression model that included age, sex, BMI, 24 hour systolic BP, TGs and LDL-C, only fasting TGs (β=0.02 ± 0.01, P=0.02) were a significant correlate of 24 hour systolic BPV (Model R 2 =0.24, P=0.03). Results were the same if TC was substituted for LDL-C in the model. In conclusion, higher plasma TC, LDL-C and TGs are associated with greater 24 hour BPV among MA/O adults with obesity with only TGs being independently associated with BPV. These data suggest that greater variability in BP among MA/O adults with obesity is mediated in part through circulating TGs suggesting that TGs may be a therapeutic target to modify short-term BPV.

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A Comparative Study of Short-Term Blood Pressure Variability in Hemodialysis Patients with and without Intradialytic Hypertension

American Journal of Nephrology ◽

10.1159/000493989 ◽

2018 ◽

Vol 48 (4) ◽

pp. 295-305 ◽

Cited By ~ 5

Author(s):

Athanasios Bikos ◽

Elena Angeloudi ◽

Evangelos Memmos ◽

Charalampos Loutradis ◽

Antonios Karpetas ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Blood Pressure Variability ◽

Hemodialysis Patients ◽

Adverse Outcomes ◽

Short Term ◽

Ambulatory Bp Monitoring ◽

Average Real Variability ◽

Regular Hemodialysis ◽

Sustained Increase

Background: Short-term blood pressure (BP) variability (BPV) is associated with increased cardiovascular risk in hemodialysis. Patients with intradialytic hypertension have high risk of adverse outcomes. Whether BPV is increased in these patients is not clear. The purpose of this study was to compare short-term BPV in patients with and without intradialytic hypertension. Methods: Forty-one patients with and 82 patients without intradialytic hypertension (intradialytic SBP rise ≥10 mm Hg to > 150 mm Hg) matched in a 1: 2 ratio for age, sex, and hemodialysis vintage were included. All subjects underwent 48-h ambulatory BP monitoring during a regular hemodialysis and the subsequent interdialytic interval. Brachial and aortic BPV were calculated with validated formulas and compared between the 2 groups during the 48-h and the 44-h periods and during the 2 daytime and nighttime periods respectively. Results: During 48-h or 44-h periods and daytime or nighttime, brachial SBP/DBP and aortic SBP/DBP were significantly higher in cases than in controls. All brachial SBP/DBP BPV indexes [SD, weighted SD (wSD), coefficient-of-variation (CV) and average-real-variability (ARV)] were not significantly different between groups during the 48- or 44-h periods (48-h: SBP-ARV 11.59 ± 3.05 vs. 11.70 ± 2.68, p = 0.844, DBP-ARV: 8.60 ± 1.90 vs. 8.90 ± 1.63, p = 0.357). Analysis stratified by day or night between days 1 and 2 revealed, in general, similar results. No significant differences in dipping pattern were observed between groups. Analysis of aortic BPV had similar findings. Conclusions: BPV is similar between those with and without intradialytic hypertension. However, those with intradialytic hypertension have a sustained increase in systolic and diastolic BP during the entire interdialytic interval.

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