Relationship of Day-by-Day Blood Pressure Variability and Admission Stroke Severity in Acute Ischemic Stroke.

IF 1.1 4区医学 Q4 CLINICAL NEUROLOGY

Neurologist Pub Date : 2024-09-01 DOI:10.1097/NRL.0000000000000556

Yuan Zhu, Minghua Wu, Yawei Zheng, Xintong Wang, Jingyi Xiayang, Tianrui Zhang, Shana Wang, Zhuyuan Fang

{"title":"Relationship of Day-by-Day Blood Pressure Variability and Admission Stroke Severity in Acute Ischemic Stroke.","authors":"Yuan Zhu, Minghua Wu, Yawei Zheng, Xintong Wang, Jingyi Xiayang, Tianrui Zhang, Shana Wang, Zhuyuan Fang","doi":"10.1097/NRL.0000000000000556","DOIUrl":null,"url":null,"abstract":"Objectives: Research on the association between stroke severity and day-by-day blood pressure variability (BPV) in acute ischemic stroke (AIS) is rare as the majority focus on the blood pressure (BP) or the short-term BPV. Our study aims to explore the exact roles of daily BPV through the 7-day commencement on stroke severity in AIS.Methods: The study included 633 patients with AIS, defining AIS as the time from the beginning of symptom up to 7 days with recording BP twice a day as well as calculating the daily BPV, and then matching them to the stroke severity. The logistic regression models were used to evaluate associations between stroke severity and day-by-day BPV. We used the smooth curve fitting to identify whether there was a nonlinear association. In addition, the subgroup analyses were performed using the logistic regression.Results: According to the modified National Institutes of Health Stroke Scale score, 301 (47.5%) patients were allocated to the mild stroke group and 332 (52.5%) to the moderate-to-severe stroke group. In terms of stroke categories, we found no significant difference between BP at admission or mean BP. However, the moderate-to-severe stroke group exhibited higher daily BPV. The multiple logistic regression analysis indicated that day-by-day BPV was positively correlated to stroke severity [odds ratio (OR)=1.05, 95% CI:1.01-1.1, P =0.03 for SBP-SD; OR=1.08, 95% CI:1.01-1.15, P =0.03 for SBP-CV; OR=1.04, 95% CI:1.01-1.07, P =0.015 for SBP-SV).Conclusions: High day-by-day BPV in AIS was associated with more severe stroke independent of BP levels.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"285-293"},"PeriodicalIF":1.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NRL.0000000000000556","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: Research on the association between stroke severity and day-by-day blood pressure variability (BPV) in acute ischemic stroke (AIS) is rare as the majority focus on the blood pressure (BP) or the short-term BPV. Our study aims to explore the exact roles of daily BPV through the 7-day commencement on stroke severity in AIS.

Methods: The study included 633 patients with AIS, defining AIS as the time from the beginning of symptom up to 7 days with recording BP twice a day as well as calculating the daily BPV, and then matching them to the stroke severity. The logistic regression models were used to evaluate associations between stroke severity and day-by-day BPV. We used the smooth curve fitting to identify whether there was a nonlinear association. In addition, the subgroup analyses were performed using the logistic regression.

Results: According to the modified National Institutes of Health Stroke Scale score, 301 (47.5%) patients were allocated to the mild stroke group and 332 (52.5%) to the moderate-to-severe stroke group. In terms of stroke categories, we found no significant difference between BP at admission or mean BP. However, the moderate-to-severe stroke group exhibited higher daily BPV. The multiple logistic regression analysis indicated that day-by-day BPV was positively correlated to stroke severity [odds ratio (OR)=1.05, 95% CI:1.01-1.1, P =0.03 for SBP-SD; OR=1.08, 95% CI:1.01-1.15, P =0.03 for SBP-CV; OR=1.04, 95% CI:1.01-1.07, P =0.015 for SBP-SV).

Conclusions: High day-by-day BPV in AIS was associated with more severe stroke independent of BP levels.

查看原文本刊更多论文

急性缺血性脑卒中患者逐日血压变化与入院时脑卒中严重程度的关系

目的：有关急性缺血性卒中（AIS）中风严重程度与逐日血压变异性（BPV）之间关系的研究很少见，因为大多数研究侧重于血压（BP）或短期血压变异性。我们的研究旨在探讨急性缺血性卒中患者从 7 天开始的每日血压变异对卒中严重程度的确切影响：研究纳入了 633 名 AIS 患者，将 AIS 定义为从症状开始到 7 天内每天记录两次血压以及计算每日血压值的时间，然后将它们与卒中严重程度进行匹配。逻辑回归模型用于评估卒中严重程度与逐日血压值之间的关联。我们使用平滑曲线拟合来确定是否存在非线性关联。此外，我们还使用逻辑回归进行了亚组分析：结果：根据修改后的美国国立卫生研究院卒中量表评分，301 例（47.5%）患者被分配到轻度卒中组，332 例（52.5%）被分配到中重度卒中组。就卒中类别而言，我们发现入院时血压和平均血压之间没有显著差异。然而，中重度卒中组的每日血压值较高。多重逻辑回归分析表明，逐日血压值与卒中严重程度呈正相关[几率比（OR）=1.05，95% CI：1.01-1.1，SBP-SD=0.03；OR=1.08，95% CI：1.01-1.15，SBP-CV=0.03；OR=1.04，95% CI：1.01-1.07，SBP-SV=0.015]：结论：AIS 患者逐日高 BPV 与更严重的卒中相关，与血压水平无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neurologist 医学-临床神经学

CiteScore

1.90

自引率

0.00%

发文量

151

审稿时长

2 months

期刊介绍： The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.