Ambulatory blood pressure profile and stroke recurrence

Area of Science:

• Cardiology
• Neurology
• Hypertension Research

Background:

• Ambulatory blood pressure (ABP) monitoring is crucial for cardiovascular risk assessment.
• Conventional ABP parameters may not fully capture the complexity of blood pressure variability.
• Identifying novel ABP parameters can enhance stroke outcome prediction.

Purpose of the Study:

• To establish a novel 24-hour ambulatory blood pressure (ABP) profile parameter.
• To evaluate the performance of this new ABP profile in predicting stroke recurrence in patients with ischaemic stroke (IS) or transient ischaemic attack (TIA).

Main Methods:

• A prospective cohort of 1996 IS/TIA patients underwent 24-hour ABP monitoring.
• Systolic blood pressure (SBP) profiles were identified using advanced functional clustering.
• Cox proportional hazards models assessed associations between profile groups, conventional ABP, and stroke recurrence.

Main Results:

• Three distinct 24-hour SBP profiles were identified.
• Profile 3, characterized by sustained higher nocturnal SBP, showed a significantly higher risk of stroke recurrence (HR 1.76) compared to Profile 1.
• Conventional ABP parameters did not show significant associations with stroke recurrence.

Conclusions:

• The 24-hour ambulatory SBP profile is a valuable tool for assessing short-term stroke recurrence risk.
• This novel ABP profiling method may improve the identification of patients at higher risk for stroke recurrence.
• ABP profiles capture additive effects of individual parameters, offering enhanced predictive value.