Blood pressure variability and the development of early neurological deterioration following acute ischemic stroke

Jong Won Chung, Nayoung Kim, Jihoon Kang, Su Hyun Park, Wook Joo Kim, Youngchai Ko, Jung Hyun Park, Ji Sung Lee, Juneyoung Lee, Mi Hwa Yang, Myung Suk Jang, Chang Wan Oh, O. Ki Kwon, Cheol Kyu Jung, Beom Joon Kim, Moon Ku Han, Philip B. Gorelick, Hee Joon Bae

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objectives: Early neurological deterioration (END) is a common condition associated with poor outcome after acute ischemic stroke. We studied association between blood pressure (BP) variability and development of END. Methods: In this retrospective observational study, we studied a consecutive series of patients hospitalized for acute ischemic stroke within 24h of onset. The primary outcome of interest was the development of END according to predefined criteria within the first 72h of stroke onset. During this period, the mean, maximum (max), and minimum (min) values for the SBP and DBP were measured. The following parameters of BP variability were calculated for the SBP and DBP: the difference between the maximum and minimum (max-min), the SD, and the coefficient of variation. Results: Of the 1161 patients enrolled in the study (mean age, 67.5±13.3 years; 59.6% men), 210 (18.1%) developed END. All of the BP variability parameters were linearly associated with END independent of mean BP and potential clinical variables (P values<0.05 on likelihood ratio tests for trend), except for SBPmax-min. Among the other BP parameters, SBPmean, SBPmax, DBPmax, and DBPmin were independently associated with END. After adjustments for potential confounders, the odds for END increased 14-21% with each increase of one standard deviation in the BP variability parameter. Conclusion: BP variability is independently and linearly associated with the development of neurologic deterioration in acute stage of ischemic stroke.

Original languageEnglish
Pages (from-to)2099-2106
Number of pages8
JournalJournal of Hypertension
Volume33
Issue number10
DOIs
Publication statusPublished - 2015 Jan 1

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Stroke
Blood Pressure
Nervous System
Observational Studies
Retrospective Studies

Keywords

  • blood pressure
  • cerebral infarction
  • prognosis
  • risk factors

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Blood pressure variability and the development of early neurological deterioration following acute ischemic stroke. / Chung, Jong Won; Kim, Nayoung; Kang, Jihoon; Park, Su Hyun; Kim, Wook Joo; Ko, Youngchai; Park, Jung Hyun; Lee, Ji Sung; Lee, Juneyoung; Yang, Mi Hwa; Jang, Myung Suk; Oh, Chang Wan; Kwon, O. Ki; Jung, Cheol Kyu; Kim, Beom Joon; Han, Moon Ku; Gorelick, Philip B.; Bae, Hee Joon.

In: Journal of Hypertension, Vol. 33, No. 10, 01.01.2015, p. 2099-2106.

Research output: Contribution to journalArticle

Chung, JW, Kim, N, Kang, J, Park, SH, Kim, WJ, Ko, Y, Park, JH, Lee, JS, Lee, J, Yang, MH, Jang, MS, Oh, CW, Kwon, OK, Jung, CK, Kim, BJ, Han, MK, Gorelick, PB & Bae, HJ 2015, 'Blood pressure variability and the development of early neurological deterioration following acute ischemic stroke', Journal of Hypertension, vol. 33, no. 10, pp. 2099-2106. https://doi.org/10.1097/HJH.0000000000000675
Chung, Jong Won ; Kim, Nayoung ; Kang, Jihoon ; Park, Su Hyun ; Kim, Wook Joo ; Ko, Youngchai ; Park, Jung Hyun ; Lee, Ji Sung ; Lee, Juneyoung ; Yang, Mi Hwa ; Jang, Myung Suk ; Oh, Chang Wan ; Kwon, O. Ki ; Jung, Cheol Kyu ; Kim, Beom Joon ; Han, Moon Ku ; Gorelick, Philip B. ; Bae, Hee Joon. / Blood pressure variability and the development of early neurological deterioration following acute ischemic stroke. In: Journal of Hypertension. 2015 ; Vol. 33, No. 10. pp. 2099-2106.
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abstract = "Objectives: Early neurological deterioration (END) is a common condition associated with poor outcome after acute ischemic stroke. We studied association between blood pressure (BP) variability and development of END. Methods: In this retrospective observational study, we studied a consecutive series of patients hospitalized for acute ischemic stroke within 24h of onset. The primary outcome of interest was the development of END according to predefined criteria within the first 72h of stroke onset. During this period, the mean, maximum (max), and minimum (min) values for the SBP and DBP were measured. The following parameters of BP variability were calculated for the SBP and DBP: the difference between the maximum and minimum (max-min), the SD, and the coefficient of variation. Results: Of the 1161 patients enrolled in the study (mean age, 67.5±13.3 years; 59.6{\%} men), 210 (18.1{\%}) developed END. All of the BP variability parameters were linearly associated with END independent of mean BP and potential clinical variables (P values<0.05 on likelihood ratio tests for trend), except for SBPmax-min. Among the other BP parameters, SBPmean, SBPmax, DBPmax, and DBPmin were independently associated with END. After adjustments for potential confounders, the odds for END increased 14-21{\%} with each increase of one standard deviation in the BP variability parameter. Conclusion: BP variability is independently and linearly associated with the development of neurologic deterioration in acute stage of ischemic stroke.",
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T1 - Blood pressure variability and the development of early neurological deterioration following acute ischemic stroke

AU - Chung, Jong Won

AU - Kim, Nayoung

AU - Kang, Jihoon

AU - Park, Su Hyun

AU - Kim, Wook Joo

AU - Ko, Youngchai

AU - Park, Jung Hyun

AU - Lee, Ji Sung

AU - Lee, Juneyoung

AU - Yang, Mi Hwa

AU - Jang, Myung Suk

AU - Oh, Chang Wan

AU - Kwon, O. Ki

AU - Jung, Cheol Kyu

AU - Kim, Beom Joon

AU - Han, Moon Ku

AU - Gorelick, Philip B.

AU - Bae, Hee Joon

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objectives: Early neurological deterioration (END) is a common condition associated with poor outcome after acute ischemic stroke. We studied association between blood pressure (BP) variability and development of END. Methods: In this retrospective observational study, we studied a consecutive series of patients hospitalized for acute ischemic stroke within 24h of onset. The primary outcome of interest was the development of END according to predefined criteria within the first 72h of stroke onset. During this period, the mean, maximum (max), and minimum (min) values for the SBP and DBP were measured. The following parameters of BP variability were calculated for the SBP and DBP: the difference between the maximum and minimum (max-min), the SD, and the coefficient of variation. Results: Of the 1161 patients enrolled in the study (mean age, 67.5±13.3 years; 59.6% men), 210 (18.1%) developed END. All of the BP variability parameters were linearly associated with END independent of mean BP and potential clinical variables (P values<0.05 on likelihood ratio tests for trend), except for SBPmax-min. Among the other BP parameters, SBPmean, SBPmax, DBPmax, and DBPmin were independently associated with END. After adjustments for potential confounders, the odds for END increased 14-21% with each increase of one standard deviation in the BP variability parameter. Conclusion: BP variability is independently and linearly associated with the development of neurologic deterioration in acute stage of ischemic stroke.

AB - Objectives: Early neurological deterioration (END) is a common condition associated with poor outcome after acute ischemic stroke. We studied association between blood pressure (BP) variability and development of END. Methods: In this retrospective observational study, we studied a consecutive series of patients hospitalized for acute ischemic stroke within 24h of onset. The primary outcome of interest was the development of END according to predefined criteria within the first 72h of stroke onset. During this period, the mean, maximum (max), and minimum (min) values for the SBP and DBP were measured. The following parameters of BP variability were calculated for the SBP and DBP: the difference between the maximum and minimum (max-min), the SD, and the coefficient of variation. Results: Of the 1161 patients enrolled in the study (mean age, 67.5±13.3 years; 59.6% men), 210 (18.1%) developed END. All of the BP variability parameters were linearly associated with END independent of mean BP and potential clinical variables (P values<0.05 on likelihood ratio tests for trend), except for SBPmax-min. Among the other BP parameters, SBPmean, SBPmax, DBPmax, and DBPmin were independently associated with END. After adjustments for potential confounders, the odds for END increased 14-21% with each increase of one standard deviation in the BP variability parameter. Conclusion: BP variability is independently and linearly associated with the development of neurologic deterioration in acute stage of ischemic stroke.

KW - blood pressure

KW - cerebral infarction

KW - prognosis

KW - risk factors

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