Day-by-Day Blood Pressure Variability and Functional Outcome after Acute Ischemic Stroke: Fukuoka Stroke Registry

Kenji Fukuda, Hisashi Kai, Masahiro Kamouchi, Jun Hata, Tetsuro Ago, Hiroshi Nakane, Tsutomu Imaizumi, Takanari Kitazono

研究成果: Contribution to journalArticle査読

48 被引用数 (Scopus)

抄録

Background and Purpose-The relationship between blood pressure (BP) variability and functional outcome in patients with acute ischemic stroke remains unclear. This study aimed to elucidate whether in-hospital day-by-day BP variability is associated with functional outcome after acute ischemic stroke. Methods-Using the Fukuoka Stroke Registry, we included 2566 patients with a first-ever ischemic stroke who had been functionally independent before the onset and were hospitalized within 24 hours. BP was measured daily, and its variability was assessed by SD, coefficients of variance, and variations independent of mean. Poor functional outcome was assessed by modified Rankin Scale scores ≥3 at 3 months. Results-After adjustment for multiple confounding factors including age, sex, risk factors, stroke features, baseline severity, thrombolytic therapy, antihypertensive agents, and mean BP, day-by-day BP variability during the subacute stage (4-10 days after onset) was independently associated with a poor functional outcome (multivariable-adjusted odds ratios [95% confidence interval] in the top versus bottom quartile of systolic BP variability, 1.51 [1.09-2.08] for SD; 1.63 [1.20-2.22] for coefficients of variance; 1.64 [1.21-2.24] for variations independent of mean). Similar trends were also observed for diastolic BP variability. These trends were unchanged in patients who were not treated with antihypertensive drugs. In contrast, no association was found between indices of BP variability during the acute stage and functional outcome after adjusting for potential confounders. Conclusions-These data suggest that intraindividual day-by-day BP variability during the subacute stage is associated with the 3-month functional outcome after acute ischemic stroke.

本文言語英語
ページ(範囲)1832-1839
ページ数8
ジャーナルStroke
46
7
DOI
出版ステータス出版済み - 7 4 2015

All Science Journal Classification (ASJC) codes

  • 臨床神経学
  • 循環器および心血管医学
  • 高度および特殊看護

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