Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Night-time diastolic blood pressure variability relates to stroke recurrence in patients who had ischaemic stroke with small artery occlusion
First author：Tingting Wang
Corresponding author：Yilong Wang
essential_information
- Person in charge：Tingting Wang
- Data Sources： BOSS
- Number of papers：BOSS20190184
- Published time：2021-11-30
2021-11-30
Published articles
Journal：Stroke & Vascular Neurology
Publication type: Article
IF(IF): 4.765
PMID: 34848565 Link To Pubmed Full text Download
Background And Purpose
The association between blood pressure variability (BPV) with stroke recurrence is unclear, but may be influenced by different subtypes of ischemic stroke (IS). Aim of this study was to investigate whether BPV measured as 24h-SD of ambulatory blood pressure was associated with certain subtypes of IS.
Method
The subtypes of IS were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. BPV was defined as SD over 24 hours weighted for the time interval between consecutive recordings and the SD of the daytime and night-time periods. Recurrent stroke was defined as a new stroke including IS or intracerebral hemorrhage. Multivariable Cox proportional risk regression model was used to assess the association between BPV and stroke recurrence in patients with different IS subtypes.
Conclusion
High night-time DBPV was associated with increased risks of stroke recurrence among IS patients with SAO subtype. Results of this study provided implications to the secondary prevention management and future researches of IS patients with SAO subtype. The association between BPV and stroke recurrence in IS patients with LAA subtype and SAO subtype should be investigated in larger, population-based studies.
Main results
In total of 1390 IS patients from BOSS study were included in present study. Multivariable analysis suggested that 24h systolic BPV (SBPV) and night-time diastolic BPV (DBPV) were significantly associated with stroke recurrence among all IS patients (HR, 2.50, 95%CI, 1.07-5.84; HR, 1.85, 95% CI, 1.07-3.21, respectively). Night-time SBPV and night-time DBPV were significantly associated with stroke recurrence in patients with SAO subtype (HR, 2.77, 95%CI, 1.07-7.15; HR, 3.60, 95%CI, 1.39-9.29, respectively). However, only night-time DBPV remained significant in patients with SAO subtype in the adjusted model (HR, 3.87; 95%CI, 1.40-10.71). Similar results were not found in IS patients with LAA subtype.