RT Journal Article
SR Electronic
T1 Ambulatory blood pressure profile and stroke recurrence
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP 352
OP 358
DO 10.1136/svn-2020-000526
VO 6
IS 3
A1 Xu, Jie
A1 Jiang, Fei
A1 Wang, Anxin
A1 Zhi, Hui
A1 Gao, Yuan
A1 Tian, Junping
A1 Mo, Jinglin
A1 Chen, Zimo
A1 Xu, An-Ding
A1 Luo, Benyan
A1 Hu, Bo
A1 Zhang, Yuqing
A1 Zhao, Xingquan
A1 Wang, Yilong
A1 Li, Hao
A1 Shen, Haipeng
A1 Wang, Yongjun
YR 2021
UL http://svn.bmj.com/content/6/3/352.abstract
AB Objectives To establish a new ambulatory blood pressure (ABP) parameter (24-hour ABP profile) and evaluated its performance on stroke outcome in ischaemic stroke (IS) or transient ischaemic attack (TIA) patients.Methods The prospective cohort consisted of 1996 IS/TIA patients enrolled for ABP monitoring and a 3-month follow-up for stroke recurrence as outcome. Profile groups of systolic blood pressure (SBP) were identified via an advanced functional clustering method, and the associations of the profile groups and conventional ABP parameters with stroke recurrence were examined in a Cox proportional hazards model.Results Three discrete profile groups (n=604, 781 and 611 in profiles 1, 2 and 3, respectively) in 24-hour ambulatory SBP were identified. Profile 1 resembled most to the normal diurnal blood pressure pattern; profile 2 also dropped at night, but climbed earlier and with higher morning surge; while profile 3 had sustained higher nocturnal SBP without significant nocturnal SBP decline. The incidence of stroke recurrence was 2.9%, 3.9% and 5.5% in profiles 1, 2 and 3, respectively. After adjustment for covariates, profile 3 was significantly associated with higher risk of stroke recurrence with profile 1 as reference (HR 1.76, 95% CI: 1.00 to 3.09), while no significant difference was observed between profiles 2 and 1 (HR 1.22, 95% CI: 0.66 to 2.25). None of conventional ABP parameters showed significant associations with the outcome.Conclusions Ambulatory 24-hour SBP profile is associated with short-term stroke recurrence. Profiles of ABP may help improve identification of stroke recurrence by capturing the additive effects of individual ABP parameters.Data are available upon reasonable request. All data are available to researchers on request for purposes of reproducing the results or replicating the procedure by directly contacting the corresponding author.