Institute of Polygenic Disease, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Medicine (Baltimore). 2022 Sep 23;101(38):e30780. doi: 10.1097/MD.0000000000030780.
Hypertension is a well-known risk factor for stroke, but the relationship between blood pressure variation (BPV) and prognosis remains unclear. This prospective observational study assessed the association between BPV and early functional outcomes in acute ischemic stroke patients. A total of 871 patients with acute ischemic stroke within 24 h of symptom onset were recruited from the Third Affiliated Hospital of Qiqihar Medical University between 2013 and 2016. Within 6 days of hospitalization, blood pressure was continuously measured from 8:00 to 9:00 every day, and the coefficient of variation (CV) of blood pressure was calculated (including systolic blood pressure [SBP] and diastolic blood pressure [DBP]). The modified Rankin scale was used to evaluate early functional outcomes at discharge. The coefficients of variation of SBP, DBP, and functional outcomes were included as primary outcome variables. Demographic characteristics and medical history were recorded as secondary outcome variables. We found that a greater CV level of SBP and DBP were associated with the poor early functional outcome at hospital discharge, and the odds ratio (OR) and 95% confidence interval (95%CI) of them were 1.56 (1.04-2.35) and 1.99 (1.31-3.03) respectively. A higher standard deviation (SD) of SBP and DBP significantly increased risk of poor early prognosis, OR (95%CI) was 1.78 (1.17-2.71) and 2.25 (1.47-3.45) respectively. Similar results were observed for SBP and DBP. The larger the range of SBP and DBP, the worse is the prognosis. In conclusion, the present study suggests that high BPV is a risk factor for poor early prognosis in acute ischemic stroke.
高血压是脑卒中的已知危险因素,但血压变异性(BPV)与预后之间的关系仍不清楚。这项前瞻性观察研究评估了急性缺血性脑卒中患者血压变异性与早期功能结局之间的关系。2013 年至 2016 年期间,我们从齐齐哈尔医科大学第三附属医院招募了 871 例发病 24 小时内的急性缺血性脑卒中患者。住院后 6 天内,每天 8:00 至 9:00 连续测量血压,并计算血压变异系数(包括收缩压[SBP]和舒张压[DBP])。采用改良 Rankin 量表评估出院时的早期功能结局。收缩压和舒张压的变异系数作为主要结局变量,人口统计学特征和病史作为次要结局变量。我们发现,SBP 和 DBP 的变异系数水平较高与出院时早期功能结局不良相关,其优势比(OR)和 95%置信区间(95%CI)分别为 1.56(1.04-2.35)和 1.99(1.31-3.03)。SBP 和 DBP 的标准差(SD)较高显著增加了不良早期预后的风险,OR(95%CI)分别为 1.78(1.17-2.71)和 2.25(1.47-3.45)。SBP 和 DBP 也观察到了类似的结果。SBP 和 DBP 的范围越大,预后越差。总之,本研究表明,高 BPV 是急性缺血性脑卒中不良早期预后的危险因素。