Increased Blood Pressure Variability Contributes to Worse Outcome After Intracerebral Hemorrhage

Stroke; a Journal of Cerebral Circulation
Adam de HavenonDavid L Tirschwell

Abstract

Background and Purpose- Increased systolic blood pressure variability (BPV) is associated with worse outcome after acute ischemic stroke and may also have a negative impact after intracerebral hemorrhage. We sought to determine whether increased BPV was detrimental in the ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage II) trial. Methods- The primary outcome of our 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. We calculated blood pressure mean and variability using systolic blood pressure from the acute period (2-24 hours postrandomization) and subacute period (days 2, 3, and 7). Results- The acute period included 913 patients and the subacute included 877. 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. Conclusions- In this secondary analysis of ATACH-2, we show that increased systolic BPV is associated with worse long-term neurological outcome. Additional research is needed to find techniques that allow early identification of...Continue Reading

References

May 30, 2013·The New England Journal of Medicine·Craig S AndersonUNKNOWN INTERACT2 Investigators
Aug 6, 2015·Stroke; a Journal of Cerebral Circulation·Lisa S ManningThompson G Robinson
Jun 9, 2016·The New England Journal of Medicine·Adnan I QureshiUNKNOWN ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network
Nov 14, 2017·The New England Journal of Medicine·Raul G NogueiraUNKNOWN DAWN Trial Investigators
Jan 6, 2018·Stroke; a Journal of Cerebral Circulation·Pil-Wook ChungUNKNOWN FAST-MAG Investigators and Coordinators

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Citations

Jul 19, 2019·Stroke; a Journal of Cerebral Circulation·Mohammad AnadaniAlejandro M Spiotta
Sep 26, 2019·The Journal of Clinical Hypertension·Michaelia D Cucci, Scott T Benken
Dec 10, 2019·Stroke; a Journal of Cerebral Circulation·Eva A MistryAdam de Havenon
Sep 21, 2019·Stroke; a Journal of Cerebral Circulation·Adam de HavenonNatalia Rost
Mar 28, 2019·Der Nervenarzt·J C Purrucker, T Steiner
Nov 24, 2020·The Journal of Clinical Hypertension·Jingjing ZhaoUNKNOWN CHASE Study Group
Oct 6, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Sasan AndalibAfshin A Divani
Mar 2, 2021·Lancet Neurology·Wendy C Ziai, Mais Al-Kawaz
May 26, 2021·Neurology·Maximiliano A Hawkes, Alejandro A Rabinstein
Sep 4, 2021·Journal of Neurointerventional Surgery·Tengfei ZhouUNKNOWN DIRECT-MT Registry Investigators
Nov 26, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Benjamin MaïerUNKNOWN BP TARGET Investigators

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