Key result
Systolic blood pressure variability was associated with stroke recurrence (OR 1.72; 95% CI 1.09-2.71), whereas diastolic variability was associated with both stroke and cardiovascular events.
Why the study?
The heterogeneity of systolic versus diastolic blood pressure variability for different vascular events in patients with acute ischaemic stroke or TIA remains unclear.
Does systolic or diastolic blood pressure variability differentially predict cardiovascular and cerebrovascular events in patients with acute ischaemic stroke or TIA?
Cohort (n=2,325)
Does systolic or diastolic blood pressure variability differentially predict cardiovascular and cerebrovascular events in patients with acute ischaemic stroke or TIA?
In patients with recent ischemic stroke or TIA, systolic blood pressure variability predicts recurrent stroke, while diastolic blood pressure variability predicts both recurrent stroke and cardiovascular events.
Answers are grounded in this paper and cite their sources.
May refine post-stroke risk stratification; leaves open whether targeting variability improves outcomes.
Background High blood pressure variability (BPV) is a novel risk factor for cardiovascular disease. However, the heterogeneity of systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV) for different vascular events remains unclear. This study aims to investigate whether SBPV or DBPV has different contribution to vascular events in patients with acute ischaemic stroke (IS) or transient ischaemic attack (TIA). Methods Data from the BOSS (blood pressure and clinical outcome in TIA or IS) study were examined for vascular events at 3-month and 1-year follow-up. BPV was defined as the SD and coefficient of variation (CV) of day-to-day measurements within 3 months after IS/TIA. Vascular events include cardiovascular events (myocardial infarction, unstable angina, cardiac death and congestive heart failure) and cerebrovascular events (ischaemic or haemorrhagic stroke). Logistic regression model was used to test the associations between BPV and vascular events. Results Of 2325 patients with IS or TIA, 103 (4.43 %) experienced a recurrent stroke and 64 (2.75 %) had cardiovascular events within 3 months. Day-to-day SBPV was only associated with stroke recurrence (BPVSD: OR, 1.72, 95% CI 1.09 to 2.71; BPVCV: 1.86, 95% CI 1.19 to 2.92), but not cardiovascular events (BPVSD: 1.67, 95% CI 0.94 to 2.94; BPVCV: 1.51, 95% CI 0.86 to 2.64). However, DBPV seems to be related to both stroke (BPVSD: 1.60, 95% CI 1.02 to 2.49; BPVCV: 1.53, 95% CI 0.99 to 2.37) and cardiovascular events (BPVSD: 2.48, 95% CI 1.37 to 4.48; BPVCV: 1.92, 95% CI 1.09 to 3.36). Similar results were found at 1 year. Conclusions For patients with IS/TIA, stroke recurrence was associated with both SBPV and DBPV; however, cardiovascular events seem to be only related to DBPV.
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Dai et al. (2020) conducted a cohort in acute ischaemic stroke (IS) or transient ischaemic attack (TIA) (n=2,325). Blood pressure variability (SBPV and DBPV) was evaluated on Stroke recurrence (OR 1.72, 95% CI 1.09-2.71). Systolic blood pressure variability was associated with stroke recurrence (OR 1.72; 95% CI 1.09-2.71), whereas diastolic variability was associated with both stroke and cardiovascular events.
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