Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke.
OBJECTIVE
We aimed to study various measures of blood pressure (BP) in the subacute phase of ischemic stroke to determine whether any of them predicted clinical outcome.


METHODS
In this retrospective observational study, a consecutive series of patients hospitalized for ischemic stroke within 48 hours of onset were enrolled. The subacute stage of stroke was defined as the time period from 72 hours of symptom onset to discharge or transfer. During this period, mean, maximum, maximum - minimum, SD, and coefficient of variation of systolic BP (SBP) and diastolic BP (DBP) were determined. A baseline severity-adjusted analysis was performed using each patient's 3-month modified Rankin Scale score as the primary outcome.


RESULTS
Among a total of 2,271 patients, the median number of BP measurements was 34 per person and the median interval from onset to discharge was 8.7 days. Measures of variability of BP were associated with poor outcome. One SD increase of maximum - minimum (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.12-1.42), SD (OR, 1.20; 95% CI, 1.07-1.34), or coefficient of variation (OR, 1.21; 95% CI, 1.09-1.35) for SBP, but not mean level of SBP (OR, 0.92; 95% CI, 0.79-1.07), was independently associated with poor outcome. Results were similar for DBP.


CONCLUSIONS
This study shows that variability of BP, but not average BP in the subacute stage of ischemic stroke, is associated with functional outcome at 3 months after stroke onset.
Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University, Seoul, Korea.
Jihoon
J
Kang
Youngchai
Y
Ko
Jung Hyun
JH
Park
Wook-Joo
WJ
Kim
Myung Suk
MS
Jang
Mi Hwa
MH
Yang
JiSung
J
Lee
Juneyoung
J
Lee
Moon-Ku
MK
Han
Philip B
PB
Gorelick
Hee-Joon
HJ
Bae
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019370:Observation; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020521:Stroke / Q000209:etiology*; D013997:Time Factors