Objective: The aim of these study is to assess the impact of in-hospital blood pressuve variability (BPV) in the acute functional outcome in patients admitted with ischaemic stroke. Design and method: An observational study was conducted in a convenience cohort of patients admitted to our unit between october 2025 to january 2026 with diagnosis of acute ischemic stroke (AIS). Patients who underwent endovascular treatment or had atrial fibrillation were excluded. Blood pressure variability was measured using Mindray ePM12 device during hospitalization and recorded in a central dataset and analyzed using standard deviation (SD) and coefficient of variation (CV) for systolic (SBP), diastolic (DBP), and mean blood pressure (MBP). Pulse wave velocity (PWV) was evaluated in all patients in the first 72 hours using Sphygmocor device. The primary outcome was a favorable functional recovery at discharge, defined as a reduction in NIH Stroke Scale (NIHSS) above 4 points. Statistical analysis included the Fisher's test and multivariable logistic regression models. Results: Thirty-five patients were included (mean age 71.1 ± 10.3 years; 38.2% female). A total of 1498 BP measurements were analyzed, with minimum of 14 measures/patient. Mean SBP was 137.5 ± 19.6 mmHg, mean DBP was 75.5 ± 11.4 mmHg, and mean MBP was 96.4 ± 13.9 mmHg. Increased DBP variability was independently associated with reduced odds of achieving a reduction at least 4 points or more in NIHSS scale at discharge (OR 0.68; 95% CI 0.45–0.94; p=0.038). Similarly, higher MBP variability was associated with lower probability of neurological improvement at discharge (OR 0.65; 95% CI 0.40–0.91; p=0.034). No significant association was observed for SBP variability. Patients without favorable outcomes had higher PWV values (12.08 vs 11.00 m/s). Conclusions: Concluding, greater in-hospital variability of DBP and MBP was associated with worse short-term functional outcomes after ischemic stroke. These findings suggest that BPV, particularly affecting mean and diastolic pressures, may represent a relevant therapeutic target during hospitalization and should be further investigated in larger prospective studies. This study, even with its limitations, it's the first step to a bigger investigation in BVP and stroke patients.
Gonçalves et al. (Fri,) studied this question.