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Acute BP variability after ischaemic stroke predicts worse functional outcomes

20 Feb 2021
One of the main aims of palliative care is to treat symptoms, rather than treating the disease itself.

High blood pressure (BP) variability within 24 hours of admission for acute ischaemic stroke correlates with worse functional outcomes 30 days after, a recent study has found.

A total of 174 patients (median age, 71 years; 54 percent male) participated in the present retrospective study. Supine BP was measured every 4 hours during the first 24 hours of admission, and parameters for analysis included systolic (SBP) and diastolic (DBP), mean arterial pressure (MAP), and pulse pressure (PP). Functional outcome was measured using the modified Rankin Scale (mRS).

The researchers also used six indices to assess BP variability: standard deviation (SD), successive variation (SV), maximal successive change (MSC), coefficient of variation (CV), average real variability (ARV), and the difference between the maximum and minimum values of BP (DMM).

After 30 days, 100 patients scored ≤2 on the mRS and were deemed to have favourable functional outcomes; the remaining 74 scored 3–6 and had unfavourable outcomes.

Mean SBP (p=0.003), DBP (p=0.012), and MAP (p=0.002) differed significantly between outcome groups, such that measurements were slightly lower among those with favourable outcomes. The same was true for several measures of BP variability.

For instance, SD of SBP (p=0.025) was significantly higher among patients with unfavourable outcomes, as were the CV (p=0.005), ARV (p=0.001), and SV (p=0.000) of PP. The MSC of DBP was also significantly heightened in patients with poorer functional outcomes at 30 days. Notably, the DMM of all BP indices was significantly elevated in the group with unfavourable outcomes.

Logistic regression analysis confirmed these findings. In the completely adjusted model, higher SD (p=0.009), SV (p=0.014), ARV (p=0.019), MSC (p=0.012), and DMM (p=0.008) all significantly aggravated the risk of worse functional outcome, but only when looking at PP. No such effect was reported for the other BP indices.

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Most Read Articles
Roshini Claire Anthony, 3 days ago

The addition of methylprednisolone to standard care* reduced mortality risk in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), according to a study from China.

05 Feb 2021

Primary immunodeficiency disease (PIDD) and allergies are two groups of conditions related to the immune system. However, they are uniquely different in terms of symptoms and treatment.

3 days ago
Waist circumference (WC) trajectories are predictive of altered risk of cardiovascular disease (CVD) among adults, even among those without body mass index (BMI)-defined obesity, a study has shown. Such association appears higher in younger adults.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.