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Dipping Pattern and 1-year stroke functional outcome in ischemic stroke or transient ischemic attack.
Xia Ding1, Yilun Zhou1, Yuesong Pan2,3
1Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|December 6, 2022
Summary
Reverse dipping, a blood pressure pattern, was common in stroke patients. It was linked to worse functional outcomes one year after the event, suggesting a need for more research.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Blood pressure dipping patterns, specifically nocturnal systolic blood pressure changes, are associated with cardiovascular health.
- Understanding these patterns in acute ischemic stroke (IS) or transient ischemic attack (TIA) patients may offer insights into prognosis.
Purpose of the Study:
- To investigate the relationship between blood pressure dipping patterns and 1-year functional outcomes in patients following acute IS or TIA.
Main Methods:
- Utilized data from the Blood Pressure and Clinical Outcome in TIA or Ischemic Stroke Study (BOSS).
- Ambulatory blood pressure monitoring was conducted during hospitalization for 1808 IS/TIA patients.
- Dipping patterns (dipper, non-dipper, reverse dipper) were defined based on nocturnal systolic blood pressure fall; poor functional outcome was defined as modified Rankin Scale (mRS) score of 3-5.
- Logistic regression analysis was employed to assess the association.
Main Results:
- Reverse dippers constituted 27.60% of the cohort.
- Poor functional outcome at 1 year was more frequent in reverse dippers (22.44%) compared to dippers (16.14%) and non-dippers (16.53%) (P = .014).
- Univariate analysis indicated reverse dipping as a risk factor for poor outcome (OR 1.504), but this association was not significant after adjusting for confounders.
Conclusions:
- Reverse dipping is a prevalent blood pressure pattern among patients with IS/TIA.
- The observed higher incidence of poor functional outcomes in reverse dippers warrants further investigation to clarify its clinical significance and underlying mechanisms.
