The blood pressure variability in patients with cryptogenic stroke

Area of Science:

• Cardiology
• Neurology
• Hypertension Research

Background:

• Increased nighttime blood pressure variability (BPV) is associated with stroke.
• Left atrial (LA) enlargement is a key indicator of structural remodeling due to pressure/volume overload.
• Blood pressure significantly influences LA enlargement.

Purpose of the Study:

• To evaluate BPV as a risk factor for cryptogenic stroke.
• To assess the relationship between BPV and LA remodeling in cryptogenic stroke patients.
• To highlight the importance of ambulatory blood pressure monitoring (ABPM) in stroke workup.

Main Methods:

• Prospective, cross-sectional cohort study.
• Included 108 cryptogenic ischemic stroke patients (Group I) and 100 controls (Group II).
• Measured maximal and minimal LA volume index (LAVI) and LA ejection fraction (LAEF) using ABPM.

Main Results:

• Group I patients exhibited significantly higher Min LAVI, Max LAVI, and lower LAEF compared to Group II (P<0.008).
• Group I patients had significantly higher BPV (SD parameters) than Group II (P=0.001).
• BPV parameters positively correlated with LA remodeling parameters; age, night systolic SD, and night diastolic SD independently predicted LA remodeling.

Conclusions:

• Cryptogenic stroke patients show higher short-term BPV, LA enlargement, and lower LAEF.
• Close monitoring of BPV is valuable for both primary and secondary prevention of ischemic stroke.