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Published on: April 23, 2021
Correlation between risk factors of cognitive dysfunction and blood pressure variability after acute ischemic stroke
Meng Sun1, Zhibin Chen1, Guoyi Li1
1Shanghai Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China.
Insights
Cognitive dysfunction after stroke is linked to high homocysteine, blood pressure variability, and infarction history. A new model effectively predicts high-risk individuals for targeted interventions.
Area of Science:
- Neurology
- Cardiology
- Gerontology
Background:
- Cognitive dysfunction is a common complication following acute ischemic stroke.
- Understanding risk factors and developing predictive models are crucial for early intervention.
Purpose of the Study:
- To explore the relationship between risk factors for cognitive dysfunction and blood pressure variability in patients with acute ischemic stroke.
- To establish a predictive model for early identification of high-risk individuals and inform targeted prevention strategies.
Main Methods:
- Spearman correlation analysis was used to assess the relationship between blood pressure variability and cognitive assessment scores.
- A partial regression coefficient model and receiver operating characteristic (ROC) curve analysis were employed to identify and evaluate independent risk factors.
Main Results:
- The developed clinical prediction model demonstrated significantly higher effectiveness in predicting cognitive impairment risk compared to single factors (P < 0.05).
- Key predictors identified include high homocysteine levels, high standard deviation of systolic blood pressure, previous infarction history, and infarction in cognitive function areas.
Conclusions:
- Cognitive dysfunction post-acute ischemic stroke is associated with elevated homocysteine, significant systolic blood pressure variability, and specific infarction patterns.
- The established prediction model shows significant value in identifying patients at risk for cognitive dysfunction, highlighting the link between cognitive function and blood pressure variability.
Abstract:
Abstract：Objective: To explore the relationship between risk factors of cognitive dysfunction and blood pressure variability after acute ischemic stroke in northwest Shanghai to establish a model for early identification of high-risk groups of cognitive dysfunction and formulation of more targeted prevention and treatment measures. Methods: Spearman test was used to evaluate the correlation between blood pressure variability and Montreal Cognitive Assessment (MoCA) score in patients with acute ischemic stroke and the partial regression coefficient model was constructed based on the above independent risk factors, and the receiver operating characteristic (ROC) curve was described to analyze the relevant independent risk factors. Results: ROC curve analysis results showed that the clinical prediction model was significantly more effective than a single factor in predicting the risk of cognitive impairment after acute ischemic stroke in northwest Shanghai（P < 0.05）. Conclusion: Cognitive dysfunction after acute ischemic stroke was closely related to high Homocysteine (Hcy) levels, high standard deviation of systolic blood pressure, previous infarction history and infarction of cognitive function area in northwest Shanghai. The prediction model based on the above factors showed satisfactory value in predicting of cognitive dysfunction risk after acute ischemic stroke and there was also the correlation between cognitive function and blood pressure variability.
Related Concept Videos
01:28Factors affecting Blood pressure
Physiological Factors:
01:23Assessment of blood pressure in brachial artery(two-step method)
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.