Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke
Background. Although research suggests that blood pressure variability (BPV) is detrimental in the weeks to months after acute ischemic stroke, it has not been adequately studied in the acute setting. Methods. We reviewed acute ischemic stroke patients from 2007 to 2014 with anterior circulation str...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2016/7670161 |
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| author | Adam de Havenon Alicia Bennett Gregory J. Stoddard Gordon Smith Haimei Wang Jana Wold Lee Chung David L. Tirschwell Jennifer J. Majersik |
| author_facet | Adam de Havenon Alicia Bennett Gregory J. Stoddard Gordon Smith Haimei Wang Jana Wold Lee Chung David L. Tirschwell Jennifer J. Majersik |
| author_sort | Adam de Havenon |
| collection | DOAJ |
| description | Background. Although research suggests that blood pressure variability (BPV) is detrimental in the weeks to months after acute ischemic stroke, it has not been adequately studied in the acute setting. Methods. We reviewed acute ischemic stroke patients from 2007 to 2014 with anterior circulation stroke. Mean blood pressure and three BPV indices (standard deviation, coefficient of variation, and successive variation) for the intervals 0–24, 0–72, and 0–120 hours after admission were correlated with follow-up modified Rankin Scale (mRS) in ordinal logistic regression models. The correlation between BPV and mRS was further analyzed by terciles of clinically informative stratifications. Results. Two hundred and fifteen patients met inclusion criteria. At all time intervals, increased systolic BPV was associated with higher mRS, but the relationship was not significant for diastolic BPV or mean blood pressure. This association was strongest in patients with proximal stroke parent artery vessel occlusion and lower mean blood pressure. Conclusion. Increased early systolic BPV is associated with worse neurologic outcome after ischemic stroke. This association is strongest in patients with lower mean blood pressure and proximal vessel occlusion, often despite endovascular or thrombolytic therapy. This hypothesis-generating dataset suggests potential benefit for interventions aimed at reducing BPV in this patient population. |
| format | Article |
| id | doaj-art-a398525a444047bd8a71c47e1621ba86 |
| institution | OA Journals |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-a398525a444047bd8a71c47e1621ba862025-08-20T02:20:20ZengWileyStroke Research and Treatment2090-81052042-00562016-01-01201610.1155/2016/76701617670161Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic StrokeAdam de Havenon0Alicia Bennett1Gregory J. Stoddard2Gordon Smith3Haimei Wang4Jana Wold5Lee Chung6David L. Tirschwell7Jennifer J. Majersik8Department of Neurology, University of Utah, Salt Lake City, UT, USADepartment of Neurology, University of Utah, Salt Lake City, UT, USADepartment of Internal Medicine, University of Utah, Salt Lake City, UT, USADepartment of Neurology, University of Utah, Salt Lake City, UT, USADepartment of Neurology, University of Utah, Salt Lake City, UT, USADepartment of Neurology, University of Utah, Salt Lake City, UT, USADepartment of Neurology, University of Utah, Salt Lake City, UT, USADepartment of Neurology, University of Washington, Seattle, WA, USADepartment of Neurology, University of Utah, Salt Lake City, UT, USABackground. Although research suggests that blood pressure variability (BPV) is detrimental in the weeks to months after acute ischemic stroke, it has not been adequately studied in the acute setting. Methods. We reviewed acute ischemic stroke patients from 2007 to 2014 with anterior circulation stroke. Mean blood pressure and three BPV indices (standard deviation, coefficient of variation, and successive variation) for the intervals 0–24, 0–72, and 0–120 hours after admission were correlated with follow-up modified Rankin Scale (mRS) in ordinal logistic regression models. The correlation between BPV and mRS was further analyzed by terciles of clinically informative stratifications. Results. Two hundred and fifteen patients met inclusion criteria. At all time intervals, increased systolic BPV was associated with higher mRS, but the relationship was not significant for diastolic BPV or mean blood pressure. This association was strongest in patients with proximal stroke parent artery vessel occlusion and lower mean blood pressure. Conclusion. Increased early systolic BPV is associated with worse neurologic outcome after ischemic stroke. This association is strongest in patients with lower mean blood pressure and proximal vessel occlusion, often despite endovascular or thrombolytic therapy. This hypothesis-generating dataset suggests potential benefit for interventions aimed at reducing BPV in this patient population.http://dx.doi.org/10.1155/2016/7670161 |
| spellingShingle | Adam de Havenon Alicia Bennett Gregory J. Stoddard Gordon Smith Haimei Wang Jana Wold Lee Chung David L. Tirschwell Jennifer J. Majersik Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke Stroke Research and Treatment |
| title | Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke |
| title_full | Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke |
| title_fullStr | Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke |
| title_full_unstemmed | Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke |
| title_short | Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke |
| title_sort | increased blood pressure variability is associated with worse neurologic outcome in acute anterior circulation ischemic stroke |
| url | http://dx.doi.org/10.1155/2016/7670161 |
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