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BP Variability Leads to Worse Outcome After Stroke

Stroke; ePub 2018 Jul 16; de Havenon, Majersik, et al

In a secondary analysis of ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage II) trial, researchers demonstrate that increased systolic blood pressure variability (BPV) is associated with worse long-term neurological outcome following acute ischemic stroke. The primary outcome of this study was a 3-month follow-up modified Rankin Scale of 3 to 6, and the secondary outcome was a utility-weighted modified Rankin Scale. Researchers calculated blood pressure mean and variability using systolic blood pressure from the acute period (2-24 hours post-randomization) and subacute period (days 2, 3, and 7). The acute period included 913 patients and the subacute included 877. They found:

  • For 5 different statistical measures of systolic BPV, there was a consistent association between increased BPV and worse neurological outcome in both the acute and subacute periods.
  • This association was not found for systolic blood pressure mean.

Citation:

de Havenon A, Majersik JJ, Stoddard G, et al. Increased blood pressure variability contributes to worse outcome after intracerebral hemorrhage. An analysis of ATACH-2. [Published online ahead of print July 16, 2018]. doi:10.1161/STROKEAHA.118.022133.

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