Pulse pressure linked to long-term stroke outcomes among older patients
There appears to be a significant association between pulse pressure (PP) and long-term stroke outcomes, and this relationship is evident among patients aged older than 60 years, a study has found.
Researchers looked at 4,195 patients (mean age 61.2 years; 68.4 percent male) with first-ever ischaemic stroke within 3 months of enrolment from The Standard Medical Management in Secondary Prevention of Ischemic Stroke in China (SMART) II study. The patients were stratified by age (<60 and ≥60 years) and had their baseline blood pressure (BP) measured. Study endpoints included the combined endpoints of recurrent vascular events and all-cause mortality, and recurrent stroke.
In the <60 years age group, BP components (systolic [S]BP, diastolic [D]BP, mean arterial pressure [MAP] and PP) had no significant association with long-term stroke outcomes. In the ≥60 years age group, PP was significantly related with the combined endpoints (hazards ratio [HR], 1.35; 95 percent CI, 1.18 to 1.54) and recurrent stroke (HR, 1.46; 1.24 to 1.72).
When dual BP components of SBP and PP, DBP and PP, or MAP and PP were analysed, SBP, DBP or MAP did not provide incremental value for predicting long-term stroke outcomes.
The present data indicate that PP within 3 months after ischaemic stroke is associated with 2-year outcomes of the combined endpoints and recurrent stroke among patients aged older than 60 years. Researchers noted that for every 1-SD increase in PP, there was a 35-percent increase in the risk of recurrent vascular events and all-cause mortality and a 46-percent increase in the risk of recurrent stroke.
“Higher PP, considered as an indicator or consequence of aortic stiffening, might [worsen] the long-term prognosis under stroke conditions,” researchers said.