Association of 24-hour blood pressure variability with functional outcome on discharge and midterm outcome in patients with acute ischemic stroke
10.3760/cma.j.issn.1671-8925.2017.07.006
- VernacularTitle:脑梗死急性期24h血压变异与患者早、中期预后的关系研究
- Author:
Zhu SHI
1
;
Shujun ZHONG
;
Shuen LI
;
Weicheng ZHENG
;
Ruilan LI
Author Information
1. 523018,东莞市人民医院神经内科
- Keywords:
Blood pressure;
Stroke;
Prognosis
- From:
Chinese Journal of Neuromedicine
2017;16(7):682-687
- CountryChina
- Language:Chinese
-
Abstract:
Objective To elucidate whether 24-hour blood pressure (BP) variability in the acute phase of ischemic stroke is associated with functional outcomes.Methods Case-control study was performed in patients with acute ischemic stroke admitted to our hospital from January 2013 to December 2015.Clinical data and 24-hour continuous BP monitoring data right after admission were recorded,and BP variability profiles were subsequently calculated.Functional outcomes were evaluated with modified Rankin scale (mRS) on discharge and at 6 months after discharge respectively (favorable outcome:mRS scores ＜2;poor outcome:mRS scores＞2).BP variability profiles were compared with distinctive functional outcomes.Logistic regression models were established to investigate factors contributing to poor outcome on discharge and at 6 months after discharge.Results Of 188 eligible patients,67 (35.6％) discharged with poor outcome and 95 (50.5％) were reported poor outcome at 6 months follow-up.Patients with poor outcome on discharge had significantly higher 24-hour mean systolic blood pressure (SBP,[149.6±20.0] mmHg vs.[137.6±20.2] mmHg) and SBP standard variation (SBP-SD,[13.4±3.8] mmHg vs.[12.1±3.8] mmHg,P＜0.05).After adjusting for crude variables,the increase of 24-hour mean SBP and SBP-SD was independently associated with poor outcome on discharge (OR=1.284,95％CI=1.067-1.544,P=0.008;OR=1.098,95％CI=1.016-1.188,P=0.019).Patients with poor outcome at 6 month after discharge had significantly higher 24-hour mean SBP ([146.6±20.6] mmHg vs.[137.1 ± 20.2] mmHg,P＜0.05).Conelusion Increased 24-hour BP variability after admission is associated with early functional outcome in patients with acute ischemic stroke,but not with midterm outcome.
