Blood pressure variability in subacute stage and risk of major vascular events in ischemic stroke survivors
- Authors
- Kang, Jihoon; Kim, Beom Joon; Yang, Mi Hwa; Jang, Myung Suk; Han, Moon-Ku; Lee, Ji Sung; Gorelick, Philip B.; Lee, Juneyoung; Bae, Hee-Joon
- Issue Date
- 10월-2019
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- blood pressure; cerebral infarction; prognosis; stroke
- Citation
- JOURNAL OF HYPERTENSION, v.37, no.10, pp.2000 - 2006
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF HYPERTENSION
- Volume
- 37
- Number
- 10
- Start Page
- 2000
- End Page
- 2006
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/62592
- DOI
- 10.1097/HJH.0000000000002126
- ISSN
- 0263-6352
- Abstract
- Background: We aimed to investigate whether blood pressure (BP) in the subacute stage of ischemic stroke affects subsequent vascular events after acute ischemic stroke. Methods: From a prospective stroke registry database, consecutive ischemic stroke patients arriving within 48 h of onset were identified. The mean and SD of SBP per patient (SBPmean and SBPSD) in the subacute stage (from 72 h of onset to discharge), were calculated. Primary outcome was a composite of stroke, myocardial infarction and vascular death that occurred within 1 year after hospital discharge. A Cox proportional hazards model was applied to elucidate whether the increase of SBPmean and SBPSD would increase the hazards of the primary outcome. Results: Of 4415 patients (age, 66.7 +/- 13.2 years; men, 69.5%), mean +/- SD of SBPmean and SBPSD in the subacute stage was 137.3 +/- 15.4 and 13.3 +/- 3.9 mmHg, respectively. Primary outcome events occurred in 6.9% during the first year after stroke. There was a significant dose-response relationship between the SBPSD and the risk of the primary outcome (P = 0.004), but not between SBPmean and the risk (P = 0.78). Interpolating the change of adjusted hazard ratio using restricted cubic spine function suggested an existence of a threshold effect of SBPSD and a U-shaped relationship of SBPmean for the composite event. Conclusion: This study shows that BP variability but not mean BP in the subacute stage of ischemic stroke may increase 1-year risk of major vascular events in patients surviving its acute stage.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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