Impact of Blood Pressure Variability in the First Three Hours of Acute Ischemic Stroke on 90-day Mortality

2005 ◽  
Vol 12 (Supplement 1) ◽  
pp. 95-96
Author(s):  
L. G. Stead
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Blood Pressure Variability

Abstract 16967: Increased Blood Pressure Variability is Associated With Worse Outcome in Acute Ischemic Stroke

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Adam de Havenon ◽  
Haimei Wang ◽  
Greg Stoddard ◽  
Lee Chung ◽  
Jennifer Majersik
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Blood Pressure Variability ◽  
Harmful Effect ◽  
Final Analysis ◽  
Ordinal Logistic Regression ◽  
Stroke Severity ◽  
The Mean

Background: Increased blood pressure variability (BPV) is detrimental in the weeks to months after ischemic stroke, but it has not been adequately studied in the acute phase. We hypothesized that increased BPV in acute ischemic stroke (AIS) patients would be associated with worse outcome. Methods: We retrospectively reviewed inpatients at our hospital between 2010-2014 with an ICD-9 code of AIS; 213 were confirmed to have AIS by a vascular neurologist. A modified Rankin Score (mRS) after discharge was available in 148/213, at a mean of 86 ± 60 days. In 45/213 the discharge mRS was either 0 or 6, in which case they were included in the final analysis. BPV was measured as the standard deviation (SD) of each patient’s systolic blood pressure readings during the first 24 hours and 5 days of hospitalization (9,844 total readings), or until discharge if discharged in <5 days (Figure 1). The SBP SD was further divided in quartiles. A multivariate ordinal logistic regression with the outcome of mRS, the primary predictor of quartiles of SBP SD, and baseline NIH stroke scale (NIHSS) to control for initial stroke severity. Results: Mean±SD age was 64.2 ± 16.3 years, NIHSS was 12.6 ± 7.9, and mRS was 2.7 ± 2.1. The mean SBP SDs for the first 24 hours and 5 days were 12.1 ± 6.2 mm Hg and 14.1 ± 4.9 mm Hg. In the ordinal logistic regression model, the quartiles of SBP SD for the first 24 hours and 5 days were positively associated with higher mRS (OR = 1.37, 95% CI 1.01 - 1.74, p = 0.009; OR = 1.30, 95% CI 1.03 - 1.63, p = 0.028). This effect became even more pronounced in patients with the highest quartile of variability (OR = 2.76, 95% CI 1.29 - 5.88, p = 0.009; OR = 2.10, 95% CI 1.01 - 4.36, p = 0.046). Conclusion: In our cohort of 193 patients with AIS, there was a significant association between increased systolic BPV and worse functional outcome, after controlling for initial stroke severity. This data suggests that increased BPV may have a harmful effect for AIS patients, which warrants a prospective observational study.

scholarly journals Predictive Significance of Day-to-Day Blood Pressure Variability in Acute Ischemic Stroke for 12-Month Functional Outcomes

2017 ◽  
Vol 30 (5) ◽  
pp. 524-531 ◽  
Author(s):  
Zhu Shi ◽  
En S. Li ◽  
Jun S. Zhong ◽  
Juan L. Yuan ◽  
Lan R. Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Blood Pressure Variability

scholarly journals ASSOCIATION BETWEEN BLOOD PRESSURE VARIABILITY AND EARLY NEUROLOGICAL DETERIORATION IN ACUTE ISCHEMIC STROKE PATIENTS

2020 ◽  
Vol 7 (8) ◽  
pp. 94-99
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Significant Relationship ◽  
Blood Pressure Variability ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Exact Test ◽  
Treatment Data

Background: Variability in blood pressure is a predictor of stroke severity and causes of poor functional outcome. Blood pressure variability is one of the main predictor of the prognosis acute ischemic stroke. Blood pressure variability were independently and linearly associated with the development of early neurologic deterioration (END) in acute ischemic stroke Objective: To determine the association between blood pressure variability and END in acute ischemic stroke patients. Method: This study uses a cross sectional design. Sampling was conducted at H. Adam Malik General Hospital Medan. Samples were taken as many as 40 subjects consecutively. Blood pressure checks were perform every hour for 72 hours then an assessment of the National Institute of Health Stroke Scale (NIHSS) score at admission and the third day of treatment. Data analysis used fisher’s exact test. Results: The demographic characteristics of the study subjects were an average age of 56-<71 years, high school education level, housewife occupation and Batak ethnicity. The mean of maximum systolic blood pressure (SBP) was 151±12.16 mmHg, minimum SBP 123.15±18 mmHg, delta SBP 25.35±10.66 mmHg, maximum diastolic blood pressure (DBP) 79.7±6.01 mmHg, minimum DBP 61.77±7.32 mmHg and delta DBP 17.97±8.48 mmHg. The NIHSS day 1 score had an average of 9.55±6.73, the NIHSS day 3 score was 11.25±7.93. Most subjects experienced END. There is a significant relationship between blood pressure variability and END with a p of 0.03 (p<0.05). Conclusion: There is a significant relationship between blood pressure variability and END in patients with acute ischemic stroke.

BLOOD PRESSURE VARIABILITY IN ACUTE ISCHEMIC STROKE

2004 ◽  
Vol 22 (Suppl. 2) ◽  
pp. S105-S106
Author(s):  
D. Dicker ◽  
V. Vasilevski ◽  
M. Gofman ◽  
D. Markovitz ◽  
V. Beilin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Blood Pressure Variability

scholarly journals Day-by-Day Blood Pressure Variability Is Associated With Neurological Functional Outcome After Acute Ischemic Stroke

2020 ◽  
Vol 11 ◽  
Author(s):  
Changqiang Yang ◽  
Kai Liu ◽  
Yue Song ◽  
Shenzhen Gong ◽  
Runyu Ye ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Blood Pressure Variability ◽  
Day By Day

The Relationship between Blood Pressure Variability, Recanalization Degree, and Clinical Outcome in Large Vessel Occlusive Stroke after an Intra-Arterial Thrombectomy

2018 ◽  
Vol 46 (5-6) ◽  
pp. 279-286 ◽  
Author(s):  
Jun Young Chang ◽  
Sang Beom Jeon ◽  
Jung Hwa Lee ◽  
O-Ki Kwon ◽  
Moon-Ku Han
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Blood Pressure Variability ◽  
Target Organ Damage ◽  
Large Vessel ◽  
Stroke Patients ◽  
Short Term ◽  
The Mean

Background: Blood pressure variability (BPV) is associated with target organ damage progression and increased cardiovascular events, including stroke. The aim of this study was to evaluate the associations between short-term BPV during acute periods and recanalization degree, early neurological deterioration (END) occurrence, and functional outcomes in acute ischemic stroke patients who had undergone intra-arterial thrombectomy (IAT). Methods: We retrospectively analyzed 303 patients with large vessel occlusive stroke who underwent IAT. The following BPV parameters, measured over 24 and 48 h after IAT, were compared: the mean, SD, coefficient of variation (CV), variation independent of the mean (VIM) for both the systolic BP (SBP) and diastolic BP, and the proportion of nocturnal SBP risers. Results: BPV parameters decreased with higher recanalization degree. The mean SBP (SBPmean) over 24 and 48 h after IAT, and the SD of SBP (SBPSD), CV of SBP (SBPCV), and VIM of SBP (SBPVIM) during the 48 h following the procedure had significant associations with recanalization degree. Patients with END had higher BPV than that of those without END, and the difference was more evident for incomplete recanalization. Increased BPV was associated with a shift toward poor functional outcome at 3 months after adjustment, including recanalization degree (OR range for significant parameters, 1.26–1.64, p = 0.006 for 48 h SBPmean, p = 0.003 for 48 h SBPCV, otherwise p < 0.002). Conclusions: Short-term BPV over 24 and 48 h after IAT in acute ischemic stroke patients was related to recanalization degree, and END occurrence, and may be an independent predictor of clinical outcome.

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