Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.
Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China.
J Clin Hypertens (Greenwich). 2022 Aug;24(8):963-970. doi: 10.1111/jch.14537. Epub 2022 Jul 27.
Blood pressure(BP) varies drastically during the acute phase after stroke onset. BP level and BP variability may have a major impact on acute ischemic stroke (AIS) prognosis. However, the association between trajectories of blood pressure over time and clinical outcomes have not been established. This review sought out existing evidences for associations of systolic blood pressure (SBP) trajectories on outcomes after stroke to determine the connection between SBP trajectories and stroke prognosis. According to a pre-designed search strategy, literature search was carried out in Embase, Pubmed and Web of Science. Two authors independently evaluated study eligibility and quality, and literature data were extracted. When the literature was eligible, we perform meta-analysis to determine associations of SBP trajectories with clinical outcomes. Seven studies were finally screened out of 52 studies retrieved. Seven studies received a good risk of bias rating and reported BP measurement methods and intervals, BP trajectories modeling methods, outcome measures, but it was found that final systolic BP trajectories in various papers were significantly different. All studies reported statistically significant associations between systolic blood pressure trajectories and prognosis. Methodological heterogeneity is observed in studies. However, this systematic review suggests that the high SBP group after AIS is related to poor clinical outcomes, while the rapid decline or medium-to-low or low SBP group is associated with relatively better clinical outcomes at different period after stroke. More prospective studies are needed to report the full methodology according to standardized criteria and explore relationships between SBP trajectories and prognosis of stroke.
血压在中风发作后的急性期会发生剧烈变化。血压水平和血压变异性可能对急性缺血性中风（AIS）的预后有重大影响。然而，血压随时间变化的轨迹与临床结果之间的关系尚未建立。本综述旨在寻找与中风后结局相关的收缩压（SBP）轨迹的现有证据，以确定 SBP 轨迹与中风预后之间的联系。根据预先设计的搜索策略，在 Embase、Pubmed 和 Web of Science 中进行了文献检索。两位作者独立评估了研究的合格性和质量，并提取了文献数据。当文献合格时，我们进行荟萃分析以确定 SBP 轨迹与临床结局的相关性。最终从 52 篇检索到的文献中筛选出 7 篇。7 篇研究的偏倚风险评价较高，报告了血压测量方法和间隔、SBP 轨迹建模方法、结局指标，但发现各文献中最终的收缩压轨迹差异显著。所有研究均报告了 SBP 轨迹与预后之间存在统计学显著相关性。研究之间存在方法学异质性。然而，本系统综述表明，AIS 后 SBP 较高与临床结局较差相关，而快速下降或中低或低 SBP 组与中风后不同时期的相对较好的临床结局相关。需要更多的前瞻性研究按照标准化标准报告完整的方法，并探讨 SBP 轨迹与中风预后之间的关系。
