Patients with acute ischemic stroke and abnormal systolic blood pressure variability who achieved improved variability after antihypertensive adjustment had better 90-day outcomes (p < 0.05).
Cohort (n=75)
Does antihypertensive regimen adjustment based on 24-h ABPM improve 90-day mRS and NIHSS scores in patients with acute ischemic stroke and hypertension?
Tailored antihypertensive therapy to reduce blood pressure variability may improve 90-day functional outcomes in patients with acute ischemic stroke and hypertension.
p-value: p=<0.05
Background Individuals with hypertension exhibit high blood pressure variability (BPV), which is associated with an increased risk of acute ischemic stroke (AIS) and poor post-stroke outcomes. Therefore, managing BPV may help reduce the incidence of AIS and improve patient prognosis. Aim This prospective cohort study investigated the effects of BPV regulation on the prognosis of patients with AIS and hypertension, using modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) scores as primary outcomes to inform individualized treatment strategies. Methods Patients with AIS from December 2021 to June 2024 were included in the study and divided into two groups based on systolic BPV (SBPV) measured more than 24 h after symptom onset: the control group (SBPV 10–20%) and the observation group (SBPV outside 10–20%). The observation group received antihypertensive regimen adjustments based on 24-h ambulatory blood pressure monitoring (ABPM) during hospitalization, and the group was subsequently stratified into Groups 1 and 2 according to the improvement in SBPV assessed at the two-week outpatient follow-up after the intervention. Additionally, modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) scores were collected during the acute phase and again after 90 days. Results A total of 75 patients were included. The observation group had higher acute-phase diastolic BPV ( p 0.05) and worse 90-day mRS and NIHSS scores (p 0.05) than the control group. Despite similar baseline scores within the observation group, patients with improved SBPV (Group 1) showed better 90-day outcomes than those without improvement (Group 2) ( p 0.05). Conclusion Despite the small sample, our findings suggest that BPV may serve as a prognostic marker for functional outcomes in AIS. Tailored antihypertensive therapy aimed at reducing BPV showed a preliminary association with improved patient prognosis.
Yan et al. (Tue,) conducted a cohort in Acute ischemic stroke and hypertension (n=75). Antihypertensive regimen adjustments based on 24-h ambulatory blood pressure monitoring vs. Control group (systolic blood pressure variability 10-20%) was evaluated on Modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) scores at 90 days (p=<0.05). Patients with acute ischemic stroke and abnormal systolic blood pressure variability who achieved improved variability after antihypertensive adjustment had better 90-day outcomes (p < 0.05).