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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
10 Apr 2019
Leafy green and root vegetables containing large amounts of nitrate confer substantial defence against salt-induced increases in blood pressure, especially in the context of nonrestricted salt intake, a study has shown.
12 May 2019
Regular consumption of chili pepper is associated with reduced risk of total and cardiovascular death regardless of adherence to Mediterranean diet, according to a study from Italy.
17 Jul 2018
Higher total intake of dairy products, especially yogurt, may help reduce the risk of incident hypertension in middle-aged and older adult men and women, suggests a recent study.
19 Oct 2016
A new system called Preoperative Evaluation Clinic (PEC) workflow for cardiothoracic surgery significantly reduced the cancellation rate of elective cases at the National Heart Centre Singapore (NHCS), according to a study presented at the ASEAN Federation of Cardiology Congress (AFCC) 2016 in Yangon, Myanmar.