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.
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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Affordable Care Act and Adult Survivors of Stroke, JAMA Neurology; ePub 2018 Aug 27; Levine, et al
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Blood Pressure Drugs Lower Recurrent Stroke Risk, Cochrane; 2018 Jul 19; Zonneveld, Richard, et al
BP Variability Leads to Worse Outcome After Stroke, Stroke; ePub 2018 Jul 16; de Havenon, Majersik, et al
Readmission Rates After Thrombectomy for Stroke , J Stroke Cerebrovasc Dis; ePub 2018 Jul 3; Ramchand, et al