Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke

Jihoon Kang, Youngchai Ko, Jung Hyun Park, Wook Joo Kim, Myung Suk Jang, Mi Hwa Yang, Ji Sung Lee, Juneyoung Lee, Moon Ku Han, Philip B. Gorelick, Hee Joon Bae

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective: We aimed to study various measures of blood pressure (BP) in the subacute phase of ischemic stroke to determine whether any of them predicted clinical outcome. Methods: In this retrospective observational study, a consecutive series of patients hospitalized for ischemic stroke within 48 hours of onset were enrolled. The subacute stage of stroke was defined as the time period from 72 hours of symptom onset to discharge or transfer. During this period, mean, maximum, maximum 2 minimum, SD, and coefficient of variation of systolic BP (SBP) and diastolic BP (DBP) were determined. A baseline severity-adjusted analysis was performed using each patient's 3-month modified Rankin Scale score as the primary outcome. Results: Among a total of 2,271 patients, the median number of BP measurements was 34 per person and the median interval from onset to discharge was 8.7 days. Measures of variability of BP were associated with poor outcome. One SD increase of maximum 2 minimum (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.12-1.42), SD (OR, 1.20; 95% CI, 1.07-1.34), or coefficient of variation (OR, 1.21; 95% CI, 1.09-1.35) for SBP, but not mean level of SBP (OR, 0.92; 95% CI, 0.79-1.07), was independently associated with poor outcome. Results were similar for DBP. Conclusion: This study shows that variability of BP, but not average BP in the subacute stage of ischemic stroke, is associated with functional outcome at 3 months after stroke onset.

Original languageEnglish
Pages (from-to)2018-2024
Number of pages7
JournalNeurology
Volume79
Issue number20
DOIs
Publication statusPublished - 2012 Nov 13

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Stroke
Blood Pressure
Odds Ratio
Confidence Intervals
Observational Studies
Retrospective Studies

ASJC Scopus subject areas

  • Clinical Neurology

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Kang, J., Ko, Y., Park, J. H., Kim, W. J., Jang, M. S., Yang, M. H., ... Bae, H. J. (2012). Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke. Neurology, 79(20), 2018-2024. https://doi.org/10.1212/WNL.0b013e3182749eb8

Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke. / Kang, Jihoon; Ko, Youngchai; Park, Jung Hyun; Kim, Wook Joo; Jang, Myung Suk; Yang, Mi Hwa; Lee, Ji Sung; Lee, Juneyoung; Han, Moon Ku; Gorelick, Philip B.; Bae, Hee Joon.

In: Neurology, Vol. 79, No. 20, 13.11.2012, p. 2018-2024.

Research output: Contribution to journalArticle

Kang, J, Ko, Y, Park, JH, Kim, WJ, Jang, MS, Yang, MH, Lee, JS, Lee, J, Han, MK, Gorelick, PB & Bae, HJ 2012, 'Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke', Neurology, vol. 79, no. 20, pp. 2018-2024. https://doi.org/10.1212/WNL.0b013e3182749eb8
Kang, Jihoon ; Ko, Youngchai ; Park, Jung Hyun ; Kim, Wook Joo ; Jang, Myung Suk ; Yang, Mi Hwa ; Lee, Ji Sung ; Lee, Juneyoung ; Han, Moon Ku ; Gorelick, Philip B. ; Bae, Hee Joon. / Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke. In: Neurology. 2012 ; Vol. 79, No. 20. pp. 2018-2024.
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AU - Kim, Wook Joo

AU - Jang, Myung Suk

AU - Yang, Mi Hwa

AU - Lee, Ji Sung

AU - Lee, Juneyoung

AU - Han, Moon Ku

AU - Gorelick, Philip B.

AU - Bae, Hee Joon

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N2 - Objective: We aimed to study various measures of blood pressure (BP) in the subacute phase of ischemic stroke to determine whether any of them predicted clinical outcome. Methods: In this retrospective observational study, a consecutive series of patients hospitalized for ischemic stroke within 48 hours of onset were enrolled. The subacute stage of stroke was defined as the time period from 72 hours of symptom onset to discharge or transfer. During this period, mean, maximum, maximum 2 minimum, SD, and coefficient of variation of systolic BP (SBP) and diastolic BP (DBP) were determined. A baseline severity-adjusted analysis was performed using each patient's 3-month modified Rankin Scale score as the primary outcome. Results: Among a total of 2,271 patients, the median number of BP measurements was 34 per person and the median interval from onset to discharge was 8.7 days. Measures of variability of BP were associated with poor outcome. One SD increase of maximum 2 minimum (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.12-1.42), SD (OR, 1.20; 95% CI, 1.07-1.34), or coefficient of variation (OR, 1.21; 95% CI, 1.09-1.35) for SBP, but not mean level of SBP (OR, 0.92; 95% CI, 0.79-1.07), was independently associated with poor outcome. Results were similar for DBP. Conclusion: This study shows that variability of BP, but not average BP in the subacute stage of ischemic stroke, is associated with functional outcome at 3 months after stroke onset.

AB - Objective: We aimed to study various measures of blood pressure (BP) in the subacute phase of ischemic stroke to determine whether any of them predicted clinical outcome. Methods: In this retrospective observational study, a consecutive series of patients hospitalized for ischemic stroke within 48 hours of onset were enrolled. The subacute stage of stroke was defined as the time period from 72 hours of symptom onset to discharge or transfer. During this period, mean, maximum, maximum 2 minimum, SD, and coefficient of variation of systolic BP (SBP) and diastolic BP (DBP) were determined. A baseline severity-adjusted analysis was performed using each patient's 3-month modified Rankin Scale score as the primary outcome. Results: Among a total of 2,271 patients, the median number of BP measurements was 34 per person and the median interval from onset to discharge was 8.7 days. Measures of variability of BP were associated with poor outcome. One SD increase of maximum 2 minimum (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.12-1.42), SD (OR, 1.20; 95% CI, 1.07-1.34), or coefficient of variation (OR, 1.21; 95% CI, 1.09-1.35) for SBP, but not mean level of SBP (OR, 0.92; 95% CI, 0.79-1.07), was independently associated with poor outcome. Results were similar for DBP. Conclusion: This study shows that variability of BP, but not average BP in the subacute stage of ischemic stroke, is associated with functional outcome at 3 months after stroke onset.

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