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Blood Pressure Variability May Be a New Predictor for the Occurrence and Prognosis of Ischemic Stroke
Ke-Qiong Yan1, Qi-Si Wu1, Jun Yang1
1Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China.
Insights
High blood pressure variability (BPV) increases ischemic stroke (IS) risk and worsens outcomes. Managing BPV alongside average blood pressure is crucial for hypertensive patients to improve IS prognosis.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Hypertension Research
Background:
- Ischemic stroke (IS) remains a primary cause of death and disability globally.
- Hypertension is a major modifiable risk factor for IS, often linked to adverse outcomes.
- Elevated blood pressure variability (BPV) is increasingly recognized in hypertensive patients and associated with IS.
Approach:
- This review synthesizes current research on the association between BPV and IS.
- It examines BPV as a significant, controllable risk factor for IS development and prognosis.
- The article highlights the importance of ambulatory blood pressure monitoring in assessing BPV.
Key Points:
- Increased BPV is an independent risk factor for IS.
- Higher BPV correlates with a greater risk of IS and poorer outcomes in both acute and subacute phases.
- BPV is multifactorial, reflecting individual physiological and pathological states.
Conclusions:
- Awareness of BPV among clinicians and IS patients is essential.
- Controlling BPV, in addition to average blood pressure, is vital for hypertensive individuals.
- Personalized blood pressure management strategies should incorporate BPV monitoring and control.
Abstract:
Despite declines in morbidity and mortality in recent years, ischemic stroke (IS) remains one of the leading causes of death and disability from cerebrovascular diseases. Addressing the controllable risk factors underpins the successful clinical management of IS. Hypertension is one of the most common treatable risk factors for IS and is associated with poor outcomes. Ambulatory blood pressure monitoring has revealed that patients with hypertension have a higher incidence of blood pressure variability (BPV) than those without hypertension. Meanwhile, increased BPV has been identified as a risk factor for IS. The risk of IS is higher and the prognosis after infarction is worse with higher BPV, no matter in the acute or subacute phase. BPV is multifactorial, with alterations reflecting individual physiological and pathological changes. This article reviews the current research advances in the relationship between BPV and IS, with an attempt to raise awareness of BPV among clinicians and IS patients, explore the increased BPV as a controllable risk factor for IS, and encourage hypertensive patients to control not only average blood pressure but also BPV and implement personalized blood pressure management.
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