Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Am J Hypertens. 2017 Nov 6;30(12):1189-1195. doi: 10.1093/ajh/hpx121.
Pulse pressure (PP) is a surrogate marker of arterial stiffness. Studies on baseline PP and long-term outcomes in patients with stroke are limited. We aimed to evaluate whether PP within 3 months after ischemic stroke was associated with long-term stroke outcomes.
A total of 4,195 patients (61.2 ± 11.6 years, 68.4% men) with first-ever ischemic stroke in 3 months had baseline blood pressure (BP) measured. Study end-points were the combined end-points (recurrent vascular events and all-cause mortality) and recurrent stroke.
In the group <60 years of age, the BP components of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), or PP did not significantly correlate with long-term stroke outcomes. In the group ≥60 years of age, PP was significantly associated with combined end-points (hazards ratio [HR] = 1.35; 95% confidence interval [CI], 1.18-1.54) and recurrent stroke (HR = 1.46; 95% CI, 1.24-1.72). Combination of SBP and PP, DBP and PP, or MAP and PP, respectively, showed no incremental value of SBP, DBP, or MAP in predicting long-term stroke outcomes.
PP was significantly associated with long-term stroke outcomes, and this association was prominent in patients with stroke older than 60 years of age.
脉压(PP)是动脉僵硬度的替代标志物。关于中风患者的基线 PP 和长期结局的研究有限。我们旨在评估缺血性中风后 3 个月内的 PP 是否与长期中风结局相关。
共有 4195 名首次发生缺血性中风的患者(61.2±11.6 岁,68.4%为男性)在 3 个月内测量了基线血压(BP)。研究终点为复合终点(复发性血管事件和全因死亡率)和复发性中风。
在<60 岁的患者中,收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)或 PP 的 BP 成分与长期中风结局无显著相关性。在≥60 岁的患者中,PP 与复合终点显著相关(风险比[HR]=1.35;95%置信区间[CI],1.18-1.54)和复发性中风(HR=1.46;95%CI,1.24-1.72)。SBP 和 PP、DBP 和 PP 或 MAP 和 PP 的组合分别显示 SBP、DBP 或 MAP 预测长期中风结局的附加价值。
PP 与长期中风结局显著相关,这种相关性在年龄大于 60 岁的中风患者中更为明显。