Midterm Blood Pressure Variability Is Associated with Poststroke Cognitive Impairment: A Prospective Cohort Study

Area of Science:

• Neurology
• Cardiology
• Gerontology

Background:

• Poststroke cognitive impairment (PSCI) is a common complication following acute ischemic stroke.
• Blood pressure variability (BPV) is increasingly recognized as a potential contributor to neurological outcomes.
• Understanding the relationship between early BPV and PSCI is crucial for developing targeted interventions.

Purpose of the Study:

• To investigate the association between midterm blood pressure variability (BPV) and the development of poststroke cognitive impairment (PSCI).
• To identify specific cognitive domains affected by early BPV in patients with acute ischemic stroke.

Main Methods:

• A cohort of 796 patients with acute ischemic stroke was analyzed.
• Midterm BPV was assessed using systolic and diastolic blood pressure variability (coefficient of variation) within 7 days post-stroke.
• Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) at baseline and follow-up.

Main Results:

• The incidence of PSCI peaked at 72% at 3 months post-stroke.
• Increased blood pressure variability (coefficient of variation) in the first week after stroke was independently associated with a higher prevalence of PSCI at 3 months.
• Impairments were noted in visuoperceptual abilities, executive functions, naming, and delayed recall.

Conclusions:

• Midterm blood pressure variability in the early phase of acute ischemic stroke is an independent predictor of PSCI.
• PSCI associated with early BPV particularly affects visuoperceptual, executive, and delayed recall functions.
• These findings underscore the importance of monitoring and managing BPV in the acute phase of stroke to mitigate cognitive decline.