国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Acute-phase Blood Pressure Trajectories and Clinical Outcomes in Ischemic Stroke

第一作者：Jie Xu,Liye Dai,Zimo Chen

通讯作者：Yongjun Wang

Blood pressure Ischemic stroke Follow-up study

基本信息

2019-06-19

已发表文章

发表杂志：J Clin Hypertens

发表类型: Original Contributions

影响因子(IF): 3.738

PMID: 暂无 Pubmed原文链接 全文下载

主要研究背景及目的

High blood pressure (BP) is frequent in acute ischemic stroke (IS). However, the impact of BP change patterns during acute phase on clinical outcomes is not conclusive. This study aims to investigate the association between the acute-phase BP trajectories and clinical outcomes in IS patients with high admission BP.

方法

The cohort consisted of 316 IS patients with admission systolic BP (SBP) ≥160 mmHg. SBP trajectories during the first seven days after onset were characterized using a random-effects model. The patients were classified into three groups based on the SBP trajectory curve parameters: sustained high SBP (T1), moderate decrease (T2) and rapid decrease in SBP (T3). Poor outcomes were defined as modified Rankin scale score ≥3 in three months after onset. The relationship between SBP trajectory groups and the outcome was examined in multivariable logistic regression models

结论

These findings suggest that a decrease in BP in the acute-phase is predictive of favorable outcomes in IS patients. BP trajectories have a greater power to detect the association than individual BP values at one time-point.

主要结果

The decreasing trend was greater in the favorable than in the poor outcome group (p=0.028 for difference in linear slopes). The incidence of poor outcomes was 25.9%, 13.5% and 9.8% in T1 (n=54), T2 (n=170) and T3 (n=92) groups, respectively. Compared with T1 group, the decrease in SBP in T2 and T3 groups was significantly associated with lower risk of the poor outcome (odds ratio=0.25, 95% confidence interval=0.10~0.67, p=0.006).