title: Highly variable blood pressure as a predictor of poor cognitive outcome in patients with acute lacunar infarction.
abstract: OBJECTIVE
  Many patients develop cognitive impairment after an acute stroke. It is not clear whether blood pressure variability is a prognostic factor for cognitive impairment. We aimed to determine the association between blood pressure variability on hospital admission and cognitive outcome in patients with acute lacunar infarction.
  
  
  METHODS
  We performed a retrospective analysis on 22 men and 14 women (mean age, 61.8 years) who had completed a cognitive evaluation 3 months after onset of an acute lacunar infarction. The patients had no previous functional disability or dementia, stenosis in major cerebral arteries, cardiac embolic sources, or infarct in strategic territories for cognition. We used standard deviation and coefficient of variance as parameters of blood pressure variability, and each cognitive function test z score as an outcome parameter. We performed linear regression analysis to assess the relationship between blood pressure variability and cognition, adjusted for vascular risk factors, severity of neurologic deficits, and mean blood pressure.
  
  
  RESULTS
  High variability of both systolic and diastolic blood pressure was significantly associated with low z scores on the Controlled Oral Word Association Test and the Digit Symbol Coding test (P<0.01). High variability of diastolic blood pressure was significantly associated with low z scores on the Korean Mini-Mental State Examination and Seoul Verbal Learning Test delayed recall (P<0.01).
  
  
  CONCLUSIONS
  Highly variable blood pressure on admission for acute lacunar infarction may predict poor cognitive outcomes, especially frontal lobe dysfunction.
authors.affiliation: *Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Republic of Korea †Department of Neurology, Myongji Hospital, Goyang City, Republic of Korea.
authors.forename: Ju-Hun
authors.initials: JH
authors.lastname: Lee
authors.forename: Euna
authors.initials: E
authors.lastname: Oh
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Oh
authors.forename: Chulho
authors.initials: C
authors.lastname: Kim
authors.forename: San
authors.initials: S
authors.lastname: Jung
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Yeonwook
authors.initials: Y
authors.lastname: Kang
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Yu
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003071:Cognition; D060825:Cognitive Dysfunction / Q000209:etiology / Q000503:physiopathology; D003704:Dementia / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D059409:Stroke, Lacunar / Q000503:physiopathology* / Q000523:psychology*; D014706:Verbal Learning