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Long-term blood pressure variability strongly predicts stroke recurrence

07 Oct 2017

Long-term blood pressure variability (BPV) is more reliable than short-term BPV in predicting stroke recurrence after acute ischaemic stroke or transient ischaemic attack (TIA), a study has shown.

The present investigation included 1,764 patients (mean age 62.45 years; 32.1 percent female; mean body mass index, 24.84 kg m−2) who participated in the BOSS (blood pressure and clinical outcome in transient ischaemic attack [TIA] or ischaemic stroke) study. All patients were examined within 7 days after onset of acute ischemic stroke or TIA.

Short-term BPV was measured using 24-hour ambulatory blood pressure measurement (ABPM) during hospitalization. On the other hand, long-term BPV was determined on the basis of home blood pressure measurement (HBPM), which was taken twice daily by patients or their families from discharge to 90 days after onset of qualifying events. Variability for systolic blood pressure (SBP) was assessed as the SD and coefficients of variance (CV). The clinical outcome was recurrent stroke within 1 year.

During 1-year follow-up, stroke recurrence was reported in 106 (6 percent) patients. Recurrent stroke was significantly associated with indices of long-term BPV (SD: adjusted hazard ratio [aHR], 1.939; 95 percent CI, 1.122 to 3.351; CV: aHR, 1.955; 1.174 to 3.255), independent of mean SBP.

On the other hand, all indices of short-term BPV did not predict stroke recurrence (SD: aHR, 1.245; 0.680 to 2.280; CV: aHR, 1.142; 0.640 to 2.038).

The present data demonstrate that long-term BPV of HBPM is a stronger predictor of stroke recurrence than BPV of ABPM, researchers said.

“Therefore, performing antihypertensive treatment in secondary prevention among patients with ischaemic stroke or TIA further emphasizes the importance of not only achieving but also maintaining stable BP control in the long term,” they added.

Additional prospective studies are needed to investigate how best to measure ABPM in acute ischaemic stroke or TIA, as well as to determine the prognostic significance of measuring ABPM on stroke recurrence.

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Most Read Articles
02 Dec 2017
The risk of congenital heart disease (CHD) Is significantly higher in foetuses conceived through in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), according to a recent study.
Pearl Toh, 6 days ago
A higher dose of pitavastatin can benefit Japanese patients with stable coronary artery disease (CAD) compared with a low-dose pitavastatin, even though cardiovascular (CV) event incidence is known to be lower in Asian than Western patients, according to the REAL-CAD study presented at the AHA Scientific Sessions 2017.
01 Apr 2014
The basic life support (BLS) termination of resuscitation (TOR) rule recommends transport and continued resuscitation when cardiac arrest is witnessed by EMT-Ds, or there is a return of spontaneous circulation, or a shock is given.
03 Dec 2017
Treatment with the triple combination of amlodipine, losartan and rosuvastatin appears to be an effective therapeutic strategy for lowering blood pressure and low-density lipoprotein (LDL)-C levels in patients with comorbid hypertension and dyslipidaemia, according to a study.