Abstract
Objective: We aimed to study various measures of blood pressure (BP) in the subacute phase of ischemic stroke to determine whether any of them predicted clinical outcome. Methods: In this retrospective observational study, a consecutive series of patients hospitalized for ischemic stroke within 48 hours of onset were enrolled. The subacute stage of stroke was defined as the time period from 72 hours of symptom onset to discharge or transfer. During this period, mean, maximum, maximum 2 minimum, SD, and coefficient of variation of systolic BP (SBP) and diastolic BP (DBP) were determined. A baseline severity-adjusted analysis was performed using each patient's 3-month modified Rankin Scale score as the primary outcome. Results: Among a total of 2,271 patients, the median number of BP measurements was 34 per person and the median interval from onset to discharge was 8.7 days. Measures of variability of BP were associated with poor outcome. One SD increase of maximum 2 minimum (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.12-1.42), SD (OR, 1.20; 95% CI, 1.07-1.34), or coefficient of variation (OR, 1.21; 95% CI, 1.09-1.35) for SBP, but not mean level of SBP (OR, 0.92; 95% CI, 0.79-1.07), was independently associated with poor outcome. Results were similar for DBP. Conclusion: This study shows that variability of BP, but not average BP in the subacute stage of ischemic stroke, is associated with functional outcome at 3 months after stroke onset.
| Original language | English |
|---|---|
| Pages (from-to) | 2018-2024 |
| Number of pages | 7 |
| Journal | Neurology |
| Volume | 79 |
| Issue number | 20 |
| DOIs | |
| Publication status | Published - 2012 Nov 13 |
| Externally published | Yes |
Bibliographical note
Funding Information:J. Kang, Y. Ko, J.H. Park, W.-J. Kim, M.S. Jang, M.H. Yang, J.-S. Lee, J. Lee, and M.-K. Han report no disclosures. P. Gorelick reports serving on study steering committees for acute stroke treatment for Brainsgate (IMPACT-24) and D-Pharm (MASCI), serves as the Director of the US DIAS 4 in the acute ischemic stroke Clinical Coordinating Center for H. Lundbeck, and serves as a consultant to Genetech and Boehringer Ingelheim. H.-J. Bae received honoraria for lectures from MSD Korea, AstraZeneca Korea, BMS Korea, Sanofi Aventis Korea, Ostuka Korea, Pfizer Korea, Handok Pharmaceutical Company, and Chong Kun Dang Pharmaceutical; received funding for a trip from BMS Korea, Pfizer Korea, Dae Woong Pharmaceutical Company, and Ostuka Korea; received consultant fees from Yu Yu Pharmaceutical Company; and received compensation for board membership from Bayer Korea, Novartis Korea, MSD Korea, and Boehringer–Ingelheim Korea. Go to Neurology.org for full disclosures .
ASJC Scopus subject areas
- Clinical Neurology