title: No Association Observed Between Blood Pressure Variability During the Acute Phase of Ischemic Stroke and In-Hospital Outcomes.
abstract: Recent data suggest that blood pressure (BP) variability confers increased cardiovascular risk independently of BP. We aimed to evaluate the association between BP variability during the acute phase of ischemic stroke and the in-hospital outcome.
  
  
  
  We prospectively studied 608 consecutive patients admitted with acute ischemic stroke (39.5% males, age: 79.1±6.6 years). Variability in BP was assessed with the SD and with the coefficient of variation of systolic (SBP) and diastolic BP (DBP) during the first 2 and the first 3 days of hospitalization. The outcome was assessed with dependency rates at discharge and with in-hospital mortality.
  
  
  
  Patients who were dependent at discharge did not differ from patients who were independent in any index of BP variability. Independent predictors of dependency at discharge were age (relative risk (RR) 1.17, 95% confidence interval (CI) 1.09-1.25, P < 0.001), history of prior ischemic stroke (RR 2.08, 95% CI 1.02-4.24, P = 0.04), and National Institutes of Health Stroke Scale (NIHSS) at admission (RR 1.64, 95% CI 1.44-1.86, P < 0.001). Patients who died during hospitalization did not differ in any index of BP variability from patients who were discharged. DBP at admission was independently and directly associated with in-hospital mortality (RR 1.06, 95% CI 1.03-1.09, P < 0.001). Other independent predictors of in-hospital mortality were history of atrial fibrillation (RR 3.30, 95% CI 1.46-7.49, P = 0.004) and NIHSS at admission (RR 1.18, 95% CI 1.13-1.23, P < 0.001).
  
  
  
  Our data do not support the hypothesis of an association between BP variability and in-hospital outcomes among patients admitted for ischemic stroke.
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece. ktziomalos@yahoo.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tziomalos
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Giampatzis
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Stella D
authors.initials: SD
authors.lastname: Bouziana
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Marianna
authors.initials: M
authors.lastname: Spanou
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Kostaki
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Papadopoulou
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Stella-Maria
authors.initials: SM
authors.lastname: Angelopoulou
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tsopozidi
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Savopoulos
authors.affiliation: First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Apostolos I
authors.initials: AI
authors.lastname: Hatzitolios
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002545:Brain Ischemia / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D006115:Greece / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function; D020521:Stroke / Q000401:mortality / Q000503:physiopathology*
keywords: blood pressure variability; cerebral autoregulation; hypertension; ischemic stroke; mortality; outcome.