title: Effect of blood pressure variability on cardiovascular outcome in diabetic and nondiabetic patients with stroke.
abstract: BACKGROUND
  The association between blood pressure (BP) variability and stroke outcome is controversial, and there are few studies that have focused on the impact of BP variability in diabetic patients with stroke. Therefore, we aimed to examine the impact of BP variability on cardiovascular outcome in diabetic and nondiabetic patients with stroke.
  
  
  METHODS
  A total of 373 ischemic stroke patients with large artery atherosclerosis were recruited and followed up. Ambulatory BP monitoring was performed in all patients and divided according to the 25th and 75th percentiles interval of SD of daytime systolic BP (SBP). Kaplan-Meier analysis and Cox regression were used to assess the relationship between BP variability and cardiovascular outcomes including stroke recurrence, vascular events and cardiovascular death.
  
  
  RESULTS
  The 339 patients were included in the final analysis. During an average follow-up of 19.0 ± 5.1 months (.6-26.8 months), 69 (20.4%) cardiovascular events occurred in all patients. Kaplan-Meier analysis found that there were no differences in cardiovascular events-free survival among the different BP variability groups in diabetic patients (P = .995); however, nondiabetic patients with greater BP variability showed a lesser cardiovascular events-free survival (P = .039). Through Cox regression we found the SD of daytime SBP (hazard ratio 1.103; 95% CI 1.011-1.203) was associated with cardiovascular outcomes in nondiabetic patients with stroke.
  
  
  CONCLUSIONS
  We show that SBP variability is associated with cardiovascular outcomes in stroke patients without diabetes, but we didn't find a correlation between SBP variability and cardiovascular outcomes in stroke patients with diabetes.
authors.affiliation: Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: chbux@126.com.
authors.forename: Bu-Xing
authors.initials: BX
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jun-Ping
authors.initials: JP
authors.lastname: Tian
authors.affiliation: Department of Cardiology, Beijing Shijingshan Hospital, Capital Medical University, Beijing, China.
authors.forename: Hong-Xia
authors.initials: HX
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicines for Cerebrovascular Disease, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Feng-He
authors.initials: FH
authors.lastname: Du
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicines for Cerebrovascular Disease, Beijing, China. Electronic address: zxq@vip.163.com.
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhao
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002545:Brain Ischemia / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology*; D048909:Diabetes Complications / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D016019:Survival Analysis
keywords: Ischemic stroke; ambulatory blood pressure monitoring; blood pressure variability; diabetes mellitus; outcome