Dipping Pattern and 1-year stroke functional outcome in ischemic stroke or transient ischemic attack
第一作者:Xia Ding
2022-12-05
发表杂志:Clinical and Experimental Hypertension
发表类型: Research Article
影响因子(IF): 12.3
PMID: 36471901 Pubmed原文链接 全文下载
Elevated blood pressure (BP) is the most important modifiable risk factor for acute stroke. Recently, an abundance of studies have found that certain BP profiles acquired by ambulatory blood pressure monitoring (ABPM), such as non- and reverse dipping patterns, predicted increased hypertensive target organ damage and poor cardiovascular prognosis in general as well as in hypertensive populations. there was considerable controversy surrounding the prognostic value of dipping patterns in patients with acute ischemic stroke (IS) or transient ischemic attack (TIA). Furthermore, there is a paucity of data from large stroke cohort studies. Therefore, we investigated the relationship between dipping patterns early after acute IS/TIA onset and 1-year stroke functional outcome in a large cohort study.
Data from the Blood Pressure and Clinical Outcome in TIA or Ischemic Stroke Study (BOSS), a nationwide, hospital-based, longitudinal cohort study, was used for this study. Patients with acute IS or TIA were recruited within 7 days after onset and ambulatory blood pressure monitoring was performed during hospitalization. Patients were defined as dippers if nocturnal systolic blood pressure fell by ≥10%, non-dippers if 0–10%, and reverse dippers if < 0%. Poor functional outcome was defined as a modified Rankin Scale (mRS) score of 3–5. Logistic regression analysis was used to test the association between dipping patterns and 1-year functional outcome.
Reverse dipping was prevalent in patients with IS/TIA. The higher incidence of 1-year poor functional outcome in reverse dippers warrants further investigation.
Among the 1808 IS/TIA patients, 19.19% were dippers, 53.21% were non-dippers, and 27.60% were reverse dippers. Poor functional outcome occurred in 22.44% of reverse dippers, which was significantly higher than that of dippers (16.14%) and non-dippers (16.53%) (P = .014). A univariate analysis revealed that reverse dipping was a risk factor for poor functional outcome (Odds ratio 1.504, 95% confidence interval 1.055–2.145, P = .024). However, this significance disappeared after adjusting for confounders.