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Blood pressure variability, nocturnal heart rate variability and endothelial function predict recurrent

Irina Filchenko1,2, Nicolas Mürner1, Martijn P J Dekkers1

  • 1Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Frontiers in Cardiovascular Medicine
|November 30, 2023
PubMed

Insights

High blood pressure variability and nocturnal heart rate variability after stroke predict future cardiovascular events. Endothelial function also contributes to this risk in stroke patients.

Area of Science:

  • Cardiology
  • Neurology
  • Clinical Research

Background:

  • Cardiovascular parameters like blood pressure (BP) and heart rate (HR) predict cerebro-cardiovascular events (CCVE) in the general population.
  • Limited data exists on these predictors in acute stroke patients.
  • Recurrent CCVE pose a significant risk post-stroke.

Purpose of the Study:

  • To assess cardiovascular parameters as predictors of recurrent CCVE in acute ischemic stroke patients.
  • To investigate the prognostic value of blood pressure variability (BPV), heart rate variability (HRV), endothelial function, and arterial stiffness.
  • To analyze these parameters within the first week post-stroke.

Main Methods:

  • Secondary analysis of the prospective observational Sleep Deficiency & Stroke Outcome Study (NCT02559739).
  • Inclusion of 359 acute ischemic stroke patients from 447 recruited.
  • Assessment of 48 cardiovascular parameters within the first week post-stroke.
  • 3-year follow-up for CCVE recording.
  • Multivariate Cox regression analysis for prognostic value.

Main Results:

  • 20% of patients experienced a future CCVE.
  • High systolic blood pressure variability and nocturnal heart rate variability predicted CCVE risk.
  • Endothelial dysfunction predicted CCVE risk after adjustment for age and sex, but not cardiovascular risk factors.
  • Diurnal HR and arterial stiffness were not associated with CCVE risk.

Conclusions:

  • Elevated blood pressure variability and nocturnal heart rate variability are significant predictors of future CCVE after acute stroke.
  • Endothelial function also contributes to the risk of recurrent cerebro-cardiovascular events post-stroke.
  • These findings highlight key cardiovascular markers for risk stratification in stroke survivors.
Abstract

Keywords:
EndoPATarterial stiffnessblood pressure variabilitycardiovascular outcomecerebro-cardiovascular riskendothelial dysfunctionheart rate variabilityischemic stroke

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