Key result
Higher pre-stroke outpatient SBP linked to ~2.5-fold higher odds of poor 90-day stroke outcome.
Why the study?
Is higher mean outpatient blood pressure during the 12 months preceding stroke associated with poor functional outcome at 90 days in patients admitted with acute stroke?
Cohort (n=187)
Is higher mean outpatient blood pressure during the 12 months preceding stroke associated with poor functional outcome at 90 days in patients admitted with acute stroke?
Higher mean outpatient systolic and diastolic blood pressure during the year prior to an acute stroke is independently associated with a higher odds of poor functional outcome at 90 days, highlighting the prognostic importance of long-term pre-stroke blood pressure control.
Answers are grounded in this paper and cite their sources.
Pre-stroke BP may refine 90-day outcome prediction; extends established prognostic factors but leaves causal effects open in observational data.
The aim of this study was to analyze the association between the mean of available outpatient blood pressure (BP) measurements recorded during the 12 months preceding stroke and functional outcome at 90 days in patients with stroke, adjusting for other established prognostic factors. This was a prospective, observational study including consecutive adult patients admitted with acute stroke between October 2022 and October 2023. Pre-stroke outpatient BP data were obtained from the shared electronic medical record system of Catalonia. All available outpatient systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements recorded during the 12 months preceding stroke onset were collected. A total of 187 patients were included. Sixty patients (32.1%) had a poor functional outcome at 90 days, defined as a modified Rankin Scale (mRS) ≥ 3 (>3 in those with a previous mRS = 3). In unadjusted models, mean pre-stroke outpatient SBP and DBP and the outpatient SBP measurement closest to stroke were associated with poor functional outcome at 90 days. In the multivariate analyses adjusted for age, baseline National Institutes of Health Stroke Scale score, pre-stroke mRS, mean in-hospital SBP or DBP, type of stroke and history of atrial fibrillation, pre-stroke SBP (OR 2.52, 95% CI 1.59–4.01, per 1 SD increase, p < 0.001), and pre-stroke DBP (OR 2.78, 95% CI 1.60–4.84, p < 0.001) were associated with a poor outcome. In conclusion, higher mean outpatient BP levels during the year preceding stroke were independently associated with poor functional outcome at 90 days.
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García-Sánchez et al. (2026) conducted a cohort in Acute stroke (n=187). Mean pre-stroke outpatient blood pressure (SBP and DBP) during the 12 months preceding stroke was evaluated on Poor functional outcome at 90 days, defined as a modified Rankin Scale (mRS) ≥ 3 (>3 in those with a previous mRS = 3) (OR 2.52, 95% CI 1.59-4.01, p=<0.001). Higher 12-month pre-stroke outpatient SBP (OR 2.52, 95% CI 1.59–4.01, p<0.001) and DBP (OR 2.78, 95% CI 1.60–4.84) independently predicted poor 90-day stroke outcome.
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