Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Sci Rep. 2019 Sep 4;9(1):12758. doi: 10.1038/s41598-019-49294-8.
Recurrent stroke increases mortality and aggravates the disability of stroke patients. We hypothesized that increased inter-arm systolic blood pressure difference and inter-arm diastolic blood pressure difference would be related to recurrent stroke in non-cardioembolic stroke patients. A total of 1226 consecutive non-cardioembolic first-ever ischemic stroke patients, in whom bilateral brachial blood pressures were measured by an automated ankle-brachial index measuring device, were included in our study. Recurrent stroke was defined as newly developed neurologic symptoms with relevant lesions on brain CT and/or MRI after 7 days or hospital discharge. Inter-arm systolic and diastolic blood pressure differences ≥10 mmHg were noted in 9.7% (120/1226) and 5.0% (62/1226) of patients, respectively. During a median 24 months of follow-up, 105 (8.5%) patients experienced recurrent stroke. Patients who had inter-arm systolic blood pressure difference ≥10 mmHg showed increased risk of recurrent stroke (hazard ratio:1.77, 95% confidence interval: 1.04-3.00, p = 0.033). Moreover, inter-arm diastolic blood pressure difference ≥10 mmHg was also independently associated with increased risk of recurrent stroke (hazard ratio:2.92, 95% confidence interval: 1.59-5.34, p = 0.001). In conclusion, inter-arm blood pressure difference ≥10 mmHg may be associated with increased risk recurrent stroke in non-cardioembolic stroke patients.
复发性中风会增加死亡率，并使中风患者的残疾程度恶化。我们假设，双臂收缩压差值和双臂舒张压差值的增加与非心源性中风患者的复发性中风有关。本研究共纳入了 1226 例连续的非心源性首发缺血性中风患者，这些患者使用自动踝肱指数测量设备测量了双侧肱动脉血压。复发性中风的定义为在 7 天或出院后出现新的神经症状，伴有脑部 CT 和/或 MRI 的相关病灶。9.7%（120/1226）和 5.0%（62/1226）的患者存在臂间收缩压差值≥10mmHg 和臂间舒张压差值≥10mmHg。在中位 24 个月的随访期间，105 例（8.5%）患者发生了复发性中风。臂间收缩压差值≥10mmHg 的患者复发性中风的风险增加（风险比：1.77，95%置信区间：1.04-3.00，p=0.033）。此外，臂间舒张压差值≥10mmHg 也与复发性中风的风险增加独立相关（风险比：2.92，95%置信区间：1.59-5.34，p=0.001）。总之，臂间血压差值≥10mmHg 可能与非心源性中风患者的复发性中风风险增加有关。
