Key result
Higher systolic blood pressure variability from prior to 72 hours after intravenous thrombolysis was associated with a higher risk of recurrent stroke within 3 months (OR 5.298; 95% CI 1.339-10.968).
Why the study?
Higher blood pressure variability increases stroke risk, but the relationship between blood pressure variability and stroke outcomes was unknown in patients undergoing intravenous thrombolysis for acute ischemic stroke.
Does higher blood pressure variability increase the risk of recurrent stroke in patients undergoing intravenous thrombolysis for acute ischemic stroke?
Cohort (n=510)
No
Does higher blood pressure variability increase the risk of recurrent stroke in patients undergoing intravenous thrombolysis for acute ischemic stroke?
Odds Ratio: 5.298 (95% CI 1.339–10.968)
p-value: p=0.018
Higher blood pressure variability and mean systolic blood pressure in the 72 hours following intravenous thrombolysis for acute ischemic stroke are associated with an increased risk of recurrent stroke at 3 months.
May prompt closer post-thrombolysis BP variability monitoring; leaves open whether intervention reduces recurrent stroke.
BACKGROUND: Evidence suggests that patients with higher blood pressure variability (BPV) have a higher risk for stroke but the relationship between BPV and stroke outcomes is unknown in those who underwent intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). The objective of this study is to investigate the association among BPV, BP values and stroke outcomes. METHODS: A retrospective analysis of about 510 consecutive thrombolysis cases for AIS from January 2015 to March 2019 in a single-center database were done. Then, these patients were followed-up for 3 months. We used univariate and multivariable models to evaluate the relationship between mean BP values, BPV and the risk of stroke outcomes from prior IVT to 72 h after IVT. Meanwhile, we also used COX regression to assess the hazard ratios of stroke outcomes with BPV within 3 months. Furthermore, we tested the effect of BP level at various time-points (prior to IVT and at 0, 2, 4, 8, 12, 24, 48 and 72 h after IVT) on development of postthrombolytic stroke outcomes. RESULTS: Higher BPV from prior IVT to 72 h after IVT was associated with higher risk of stroke outcomes within 3 months [SBPV of recurrent stroke: odds ratios (OR) = 5.298, 95% confidence interval (CI) 1.339-10.968, P = 0.018; DBPV of recurrent stroke: OR = 6.397, 95% CI 1.576-25.958, P = 0.009, respectively]. In addition, patients with recurrent stroke had significantly higher mean SBP (OR=1.037, 95% CI 1.006-1.069, P = 0.019). Furthermore, higher BP at different time points were associated with greater risk of recurrent stroke from prior IVT to 72 h after IVT. CONCLUSION: Higher BPV and SBP from prior IVT to 72 h after IVT was associated with higher risk of stroke outcomes within 3 months.
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A 2022 study conducted a cohort in Acute ischemic stroke (n=510). Blood pressure variability vs. Lower blood pressure variability was evaluated on Recurrent stroke within 3 months (OR 5.298, 95% CI 1.339-10.968, p=0.018). Higher systolic blood pressure variability from prior to 72 hours after intravenous thrombolysis was associated with a higher risk of recurrent stroke within 3 months (OR 5.298; 95% CI 1.339-10.968).
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