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Stroke and Vascular Neurology

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Different contribution of SBP and DBP variability to vascular events in patients with stroke

Liye Dai, Aichun Cheng, Xiwa Hao, Jie Xu, Yingting Zuo, Anxin Wang, Xia Meng, Hao Li, Yilong Wang, Xingquan Zhao, Yongjun Wang
DOI: 10.1136/svn-2019-000278 Published 30 June 2020
Liye Dai
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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  • ORCID record for Liye Dai
Aichun Cheng
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Xiwa Hao
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
3 Department of Neurology, Inner Mongolia Baotou City Central Hospital, Baotou, China
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Jie Xu
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Yingting Zuo
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Anxin Wang
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Xia Meng
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Hao Li
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Yilong Wang
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Xingquan Zhao
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Yongjun Wang
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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    Figure 1

    Flow chart of the study.BOSS, blood pressure and clinical outcome in TIA or IS.

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    Figure 2

    Comparison of stroke and cardiovascular event rates in patients with stroke/TIA at 3 months and 1 year with high and low systolic or diastolic blood pressure variability. (A) Stroke recurrence rate in patients with stroke/TIA at 3 months in different BPV groups. (B) Cardiovascular event rate in patients with stroke/TIA at 3 months in different BPV groups. (C) Stroke recurrence rate in patients with stroke/TIA at 1 year in different BPV groups. (D) Cardiovascular event rate in patients with stroke/TIA at 1 year in different BPV groups. BPV, blood pressure variability; CV, coefficient of variation; DBP, diastolic blood pressure; SBP, systolic blood pressure; STD, standard deviation; TIA, transient ischaemic attack.

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    Figure 3

    HR for cardiovascular events and stroke recurrence within 3 months according to the quartiles of SBP variability and DBP variability. Adjusted for age, gender, body mass index, medical history (hypertension, diabetes mellitus and dyslipidaemia), qualifying event, and concomitant medication (antiplatelet, antilipid and antihypertension) and mean systolic blood pressure in 3 months. CV, coefficient of variation; DBP, diastolic blood pressure; SBP, systolic blood pressure; STD, standard deviation.

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    Figure 4

    HR for cardiovascular events and stroke recurrence within 1 year according to the quartiles of SBP variability and DBP variability. Adjusted for age, gender, body mass index, medical history (hypertension, diabetes mellitus and dyslipidaemia), qualifying event, and concomitant medication (antiplatelet, antilipid and antihypertension) and mean systolic blood pressure in 3 months. CV, coefficient of variation; DBP, diastolic blood pressure; SBP, systolic blood pressure; STD, standard deviation.

Tables

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  • Table 1

    Main baseline characteristics of participants

    VariableParticipants (N=2325)
    Age, mean±SD62.5±11.1
    Female, n (%)762 (32.8)
    BMI, mean±SD24.9±3.4
    Medical history, n (%)
     Stroke/TIA563 (24.2)
     Hypertension1636 (70.4)
     Diabetes mellitus134 (5.8)
     Dyslipidaemia242 (10.4)
     Coronary heart disease264 (11.4)
     Atrial fibrillation81 (3.5)
    Current or previous smoking, n (%)1011 (43.5)
    Moderate or heavy drinking, n (%)398 (17.1)
    Qualifying event, n (%)
     TIA266 (11.4)
     IS2059 (88.6)
    SBP 
     Mean SBP135.4±11.9
     SD-SBP9.1±4.0
     CV-SBP6.8±3.4
    DBP 
     Mean DBP79.7±8.8
     SD-DBP6.6±5.0
     CV-DBP8.2±5.8
    Concomitant medication
     Antiplatelet2258 (97.1)
     Antilipid2115 (91.0)
     Antihypertension1542 (66.3)
    • Mean SBP is mean systolic blood pressure in 3 months.

    • BMI, body mass index; CV, coefficient of variation; DBP, diastolic blood pressure; IS, ischaemic stroke; SBP, systolic blood pressure; TIA, transient ischaemic attack.

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Different contribution of SBP and DBP variability to vascular events in patients with stroke
Liye Dai, Aichun Cheng, Xiwa Hao, Jie Xu, Yingting Zuo, Anxin Wang, Xia Meng, Hao Li, Yilong Wang, Xingquan Zhao, Yongjun Wang
Stroke and Vascular Neurology Jun 2020, 5 (2) 110-115; DOI: 10.1136/svn-2019-000278

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Different contribution of SBP and DBP variability to vascular events in patients with stroke
Liye Dai, Aichun Cheng, Xiwa Hao, Jie Xu, Yingting Zuo, Anxin Wang, Xia Meng, Hao Li, Yilong Wang, Xingquan Zhao, Yongjun Wang
Stroke and Vascular Neurology Jun 2020, 5 (2) 110-115; DOI: 10.1136/svn-2019-000278
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Different contribution of SBP and DBP variability to vascular events in patients with stroke
Liye Dai, Aichun Cheng, Xiwa Hao, Jie Xu, Yingting Zuo, Anxin Wang, Xia Meng, Hao Li, Yilong Wang, Xingquan Zhao, Yongjun Wang
Stroke and Vascular Neurology Jun 2020, 5 (2) 110-115; DOI: 10.1136/svn-2019-000278
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