Xu Chuanli, Fu Zhiyong, Wu Wei, Zhang Jin, Liu Meitong, Gao Lianbo
Department of Neurology, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China.
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China.
Brain Sci. 2023 Jun 28;13(7):998. doi: 10.3390/brainsci13070998.
The determinants of blood pressure variability (BPV) are complex. We aimed to evaluate whether circulating high-sensitivity C-reactive protein (hsCRP) is associated with short-term BPV during the subacute stage of ischemic stroke. In this observational study, a consecutive series of acute ischemic stroke patients who underwent 24 h ambulator blood pressure monitoring (ABPM) during day 4 to 10 after onset were enrolled. Multivariable linear regression models were constructed to assess relationships between hsCRP and BPV. Among a total of 325 patients analyzed, the mean age was 60 years old and 72% were male. The SD, CV, ARV of 24 h SBP and DBP were more likely to be higher in patients with hsCRP ≥ 2 mg/L, and these predispositions remained unchanged in linear regression analyses after adjusting for possible confounding factors, with a dose-response relationship when patients were additionally categorized into quartiles according to hsCRP levels using the lowest quartile as a reference category. In contrast, similar results were observed for the mean of SBP but not the mean of DBP. These results indicate that hsCRP is dose-dependently associated with short-term BPV during the subacute stage of ischemic stroke. These findings suggested that patients with a higher level of hsCRP tended to have larger blood pressure fluctuations.
血压变异性（BPV）的决定因素很复杂。我们旨在评估循环高敏C反应蛋白（hsCRP）是否与缺血性卒中亚急性期的短期BPV相关。在这项观察性研究中，纳入了一系列在发病后第4至10天接受24小时动态血压监测（ABPM）的急性缺血性卒中患者。构建多变量线性回归模型以评估hsCRP与BPV之间的关系。在总共分析的325例患者中，平均年龄为60岁，72%为男性。hsCRP≥2mg/L的患者24小时收缩压（SBP）和舒张压（DBP）的标准差（SD）、变异系数（CV）、平均实际波动幅度（ARV）更有可能更高，在调整可能的混杂因素后，这些倾向在线性回归分析中保持不变，当根据hsCRP水平将患者另外分为四分位数并以最低四分位数作为参考类别时存在剂量反应关系。相比之下，SBP的平均值观察到类似结果，但DBP的平均值未观察到类似结果。这些结果表明，hsCRP在缺血性卒中亚急性期与短期BPV呈剂量依赖性相关。这些发现提示hsCRP水平较高的患者往往血压波动更大。
