Night-time diastolic blood pressure variability relates to stroke recurrence in patients who had ischaemic stroke with small artery occlusion  

作　　者：Tingting Wang Jie Xu Anxin Wang Ying Liu Xingquan Zhao Yongjun Wang Yilong Wang 

机构地区：[1]Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China [2]China National Clinical Research Center for Neurological Diseases,Beijing,China

出　　处：《Stroke & Vascular Neurology》2022年第3期237-244,共8页卒中与血管神经病学（英文）

基　　金：The study was funded by grants from the National Key R&D Program of China(no.2018YFC1312400,2018YFC1312402);the Ministry of Science and Technology of the Beijing Outstanding Young Scientist Program(BJJWZYJH01201910025030);the National Natural Science Foundation of China(no.81825007);the'Thirteenth-Five'Key Development and Research Plan by the Ministry of Science and Technology of the People’s Republic of China(no.2017YFC1307900);Supporting-Top Youth Team by Beijing Municipal Science and Technology Commission(no.2016000021223TD03).

摘　　要：Background and purpose The association between blood pressure variability(BPV)and stroke recurrence among patients who had ischaemic stroke(IS)remains unclear.This study aimed to investigate the association between BPV and stroke recurrence in patients who had IS of large artery atherosclerosis(LAA)subtype and small artery occlusion(SAO)subtype.Methods Data from the BOSS(Blood Pressure and Clinical Outcome in Transient Ischemic Attack or Ischemic Stroke)study were examined.IS subtypes were diagnosed according to the Trial of Org 10172 in Acute Stroke Treatment criteria.BPV was performed by 24-hour ambulatory blood pressure monitoring and defined through SD of blood pressure.The primary outcome was stroke recurrence within 90 days after discharge.Multivariable Cox regression model was used to assess the association between BPV and stroke recurrence in patients who had IS of LAA subtype and SAO subtype.Results A total of 1390 patients who had IS from the BOSS study were included in the present study.Multivariable analysis suggests that 24-hour systolic BPV(SBPV)and night-time diastolic BPV(DBPV)were significantly associated with stroke recurrence among all patients who had IS(HR,2.50,95%CI 1.07 to 5.84;HR,1.85,95%CI 1.07 to 3.21,respectively).Night-time SBPV and night-time DBPV were significantly associated with stroke recurrence in patients with SAO subtype(HR,2.77,95%CI 1.07 to 7.15;HR,3.60,95%CI 1.39 to 9.29,respectively).However,in the adjusted model,only night-time DBPV remained significant in patients with SAO subtype(HR,3.87,95%CI 1.40 to 10.71).Similar results were not found in patients who had IS of LAA subtype.Conclusions High night-time DBPV was associated with increased risk of stroke recurrence among patients who had IS of SAO subtype.The results of this study have implications for the secondary prevention management and future research of patients who had IS of SAO subtype.The association between BPV and stroke recurrence in patients who had IS of LAA subtype and SAO subtype should be investigated in

关 键 词：PATIENTS DIASTOLIC BLOOD 

分 类 号：R743[医药卫生—神经病学与精神病学]