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Previous study reported that acute phase systolic blood pressure (BP) trajectories were associated with subsequent clinical outcomes among patients with ischemic stroke. However, the association between discharge systolic BP trajectories and ischemic stroke prognosis is not well characterized. A total of 3479 patients with ischemic stroke with 3 BP measurements after hospital discharge from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) were included in this analysis. Discharge systolic BP trajectories were identified by latent mixture modeling. Study outcomes related to mortality, major disability, recurrent stroke, and cardiovascular events were collected 24 months after stroke onset. Logistic regression and Cox proportional hazards models were used to examine the association of systolic BP trajectories with clinical outcomes during follow-up. We identified 4 discharge systolic BP trajectories: high-stable, high-decreasing, low-increasing, and low-stable. Compared with participants in the high-stable systolic BP trajectory group, those in the high-decreasing and low-stable trajectory groups had a decreased risk of the composite outcome of death or major disability, with multiple-adjusted odds ratios (95% CIs) of 0.56 (0.31–0.97) and 0.50 (0.24–0.89), respectively, and a decreased risk of mortality, with multiple-adjusted hazard ratios (95% CIs) of 0.36 (0.13–0.99) and 0.19 (0.07–0.50), respectively. Patients in the low-stable trajectory group had the lowest risk of recurrent stroke, cardiovascular events, and the composite outcome of death or cardiovascular events. This implicates that patients with a high-decreasing or low-stable systolic BP trajectory after discharge had a lower risk of adverse clinical outcomes among patients with ischemic stroke.

Systolic Blood Pressure Trajectories After Discharge and Long-Term Clinical Outcomes of Ischemic Stroke