title: Prognostic Significance of Short-Term Blood Pressure Variability in Acute Stroke: Systematic Review.
abstract: OBJECTIVE
  Blood pressure variability (BPV) may be an important prognostic factor acutely after stroke. This review investigated the existing evidence for the effect of BPV on outcome after stroke, also considering BPV measurement techniques and definitions.
  
  
  METHODS
  A literature search was performed according to a prespecified study protocol. Two reviewers independently assessed study eligibility and quality. Where appropriate, meta-analyses were performed to assess the effect of BPV on poor functional outcome.
  
  
  RESULTS
  Eighteen studies from 1359 identified citations were included. Seven studies were included in a meta-analysis for the effect of BPV on functional outcome (death or disability). Systolic BPV was significantly associated with poor functional outcome: pooled odds ratio per 10-mm Hg increment, 1.2; confidence interval (1.1-1.3). A descriptive review of included studies also supports these findings, and in addition, it suggests that systolic BPV may be associated with increased risk of intracranial hemorrhage in those treated with thrombolytic therapy.
  
  
  CONCLUSIONS
  This systematic review and meta-analysis suggest that greater systolic BPV, measured early from ischemic stroke or intracerebral hemorrhage onset, is associated with poor longer-term functional outcome. Future prospective studies should investigate how best to measure and define BPV in acute stroke, as well as to determine its prognostic significance.
authors.affiliation: From Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Leicester, United Kingdom (L.S.M., T.G.R.); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (P.M.R.); and Faculty of Medicine and Health Sciences, Norfolk and Norwich Medical School, University of East Anglia, Norwich, United Kingdom (J.F.P.). lm313@le.ac.uk.
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Manning
authors.affiliation: From Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Leicester, United Kingdom (L.S.M., T.G.R.); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (P.M.R.); and Faculty of Medicine and Health Sciences, Norfolk and Norwich Medical School, University of East Anglia, Norwich, United Kingdom (J.F.P.).
authors.forename: Peter M
authors.initials: PM
authors.lastname: Rothwell
authors.affiliation: From Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Leicester, United Kingdom (L.S.M., T.G.R.); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (P.M.R.); and Faculty of Medicine and Health Sciences, Norfolk and Norwich Medical School, University of East Anglia, Norwich, United Kingdom (J.F.P.).
authors.forename: John F
authors.initials: JF
authors.lastname: Potter
authors.affiliation: From Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Leicester, United Kingdom (L.S.M., T.G.R.); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (P.M.R.); and Faculty of Medicine and Health Sciences, Norfolk and Norwich Medical School, University of East Anglia, Norwich, United Kingdom (J.F.P.).
authors.forename: Thompson G
authors.initials: TG
authors.lastname: Robinson
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D006801:Humans; D011379:Prognosis; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology*
keywords: blood pressure; meta-analysis; odds ratio; prospective studies; stroke