Open AccessChange in blood pressure variability in patients with acute ischemic stroke and its effect on early neurologic outcome
Author(s) -
Jihoon Kang,
Jeong Ho Hong,
Min Uk Jang,
NackCheon Choi,
Ji Sung Lee,
Beom Joon Kim,
Moon Ku Han,
Hee Joon Bae
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0189216
Subject(s) - blood pressure , medicine , stroke (engine) , cardiology , ischemic stroke , brain ischemia , ischemia , mechanical engineering , engineering
Background How short-term blood pressure variability (BPV) is affected in the acute stage of ischemic stroke and whether BPV is associated with early neurologic outcomes remains unclear. Methods Patients who admitted for ischemic stroke within 24 h of symptom onset were consecutively identified between January 2010 and January 2015. BP profiles measured in real-time were summarized into short-term, 24-h time intervals, based on standard deviation (SD) and mean of systolic BP (SBP SD ) during the first 3 days. The primary outcome was daily assessment of early neurological deterioration (END). The associations between short-term SBP SD values and the secular trend for primary outcome were examined. Results A total of 2,545 subjects (mean age, 67.1 ± 13.5 years old and median baseline National Institutes of Health Stroke Scale score, 3) arrived at the hospital an average of 6.1 ± 6.6 h after symptom onset. SBP SD values at day 1 (SD#D1), SD#D2, and SD#D3 were 14.4 ± 5.0, 12.5 ± 4.5, and 12.2 ± 4.6 mmHg, respectively. Multivariable analyses showed that SD#D2 was independently associated with onset of END at day 2 (adjusted odds ratio, 1.08; 95% confidence interval, 1.03–1.13), and SD#D3 was independently associated with END#D3 (1.07, 1.01–1.14), with adjustments for predetermined covariates, SBP mean , and interactions with daily SBP SD . Conclusion Short-term BPV changed and stabilized from the first day of ischemic stroke. Daily high BPV may be associated with neurological deterioration independent of BPV on the previous day.