Blood pressure variability and stroke outcome in patients with internal carotid artery occlusion
Laura Buratti1, Claudia Cagnetti1, Clotilde Balucani2
1Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Insights
High blood pressure variability in the acute phase of ischemic stroke with internal carotid artery (ICA) occlusion is linked to poor 3-month outcomes. This suggests BP variability may predict stroke prognosis.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Clinical Research
Background:
- Internal carotid artery (ICA) occlusion is a significant risk factor for ischemic stroke.
- Blood pressure (BP) variability is increasingly recognized as a potential predictor of stroke outcomes.
Purpose of the Study:
- To investigate the association between arterial blood pressure (BP) variability during the acute phase and 3-month clinical outcomes in patients with ischemic stroke and ICA occlusion.
- To determine if BP variability parameters can predict functional recovery after stroke.
Main Methods:
- Prospective study of 89 patients with ischemic stroke and ICA occlusion.
- Acquisition of at least 10 BP measurements within 48 hours of stroke onset.
- Analysis of BP variability using parameters like standard deviation (SD) and coefficient of variation (CV) for systolic and diastolic BP.
- Assessment of 3-month outcome using the modified Rankin Scale (mRS), adjusted for baseline stroke severity.
Main Results:
- Patients with poor 3-month outcomes exhibited significantly higher maximum BP values, max-min differences, SD, and CV for both systolic and diastolic BP compared to those with good outcomes (p<0.05).
- Multivariate adjusted models confirmed the association between elevated BP variability and adverse clinical outcomes.
Conclusions:
- Acute phase BP variability in ischemic stroke patients with ICA occlusion is associated with poor clinical outcomes.
- These findings suggest BP variability may serve as a prognostic marker for stroke recovery.
- Further research is warranted to confirm these preliminary findings and explore the underlying pathophysiology and cerebral hemodynamic changes.
Purpose:
The aim of this study was to evaluate the relationship between arterial blood pressure (BP) variability during the acute phase and the 3-month outcome in ischemic stroke patients with internal carotid artery (ICA) occlusion.
Methods:
At least 10 BP measurements during the first 48 h after stroke onset were obtained in 89 patients with ICA occlusion. BP profile was described using various parameters: average of recordings, maximum (max), minimum (min), difference between max and min (max-min), standard deviation (SD) and coefficient of variation (CV) for both systolic and diastolic BP. Outcome at 3 months was defined using the modified Rankin Scale (mRS) score corrected for baseline stroke severity.
Results:
Fifty-five patients had a good and 34 a poor outcome. Max values, max-min, SD and CV of both systolic and diastolic BP resulted significantly higher in patients with poor outcome compared to those with good outcome (p<0.05, multivariate adjusted model).
Conclusions:
In a cohort of acute ischemic stroke patients with ipsilateral ICA occlusion BP variability, assessed in the acute phase, was associated with poor clinical outcome. These preliminary exploratory findings are worthy of further study to be conducted to confirm or confute the role of BP variability in predicting stroke outcome. In order to obtain more comprehensive information, it would also be appropriate to consider the possibility of acquiring data related to the pathophysiology of stroke and to cerebral hemodynamic changes.
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