The relationship between blood pressure variability and outcome in acute ischemic stroke

Abstract

Stroke is the second most common cause of mortality. Ischemic stroke is approximately 10 times more common than haemorrhagic stroke. The strongest risk factor for ischemic stroke is hypertension, thus reduction of blood pressure decreases the risk of ischemic stroke. However, the prognostic importance of blood pressure after is unclear. The problem is even more complex considering blood pressure variability (BPV), i.e. continuous changes of blood pressure values. The aim of this review is to discuss the very short-term, short-term, mid-term, and long-term blood pressure variability in the context of clinical outcome in patients after acute ischemic stroke. Most of the studies have shown that increased BPV in ischemic stroke patients is associated with poorer prognosis, however in some of them there was not association between BPV and outcome.

Age-Associated with Worsening of Neurological Deficits in Ischemic Stroke Patients in Abdoel Wahab Sjahranie Regional Hospital, Samarinda

“…48 Compared to blood pressure, wide blood pressure variation (BPV) is associated with worsening functional outcomes in the first 7 days and 3 months after acute stroke. 49,50 Brain autoregulation is disrupted in the stroke area. If the area of healthy penumbra tissue around the ischemic core cannot regulate properly, it may be more likely to be hurt by changes in cerebral perfusion, which is linked to a wide BPV.…”

Prognostic significance of 24‐h blood pressure and variability indices in the outcome of acute ischaemic stroke

“…However, all recent relative systematic reviews conclude that there is a need for more prospective studies investigating how best to measure and define BPV in acute stroke, as well as to determine its prognostic significance. [19][20][21] The purpose of this study is to investigate the predictive value of SBP and diastolic BP (DBP) and BPV measured by 24-h ambulatory blood pressure monitoring (ABPM) methods during AIS regarding medium-term outcome.…”

“…Generally, the parameter that is most frequently reported as associated with adverse long‐term outcomes after ischaemic stroke is variability of systolic BP (SBP). However, all recent relative systematic reviews conclude that there is a need for more prospective studies investigating how best to measure and define BPV in acute stroke, as well as to determine its prognostic significance 19–21 …”

Time of blood pressure in target range in acute ischemic stroke

“…As well as BP elevation, BPV in hyperacute and acute stroke may also be of prognostic value [15,16]. However, to date, few data about its role after ischemic stroke are available and the existing results are inconsistent [17][18][19].…”