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Conference Paper: Long-term prognostic implications of visit-to-visit blood pressure variability in patients with ischaemic stroke

TitleLong-term prognostic implications of visit-to-visit blood pressure variability in patients with ischaemic stroke
Authors
Issue Date2014
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk
Citation
The 19th Medical Research Conference (MRC 2014), Hong Kong, China, 18 January 2014. In Hong Kong Medical Journal, 2014, v. 20 suppl. 1, p. 28, abstract no. 39 How to Cite?
AbstractBackground: Both blood pressure (BP) and its variability (BPV) are established risk factors for the development of atherosclerotic diseases and are associated with an increased risk of cardiovascular and all-cause mortality. The long-term prognostic implications of out-patient clinic visit-to-visit BPV among patients with ischaemic stroke are nevertheless unknown. Methods: We prospectively followed up the clinical outcome of 632 consecutive ischaemic stroke patients without atrial fibrillation. The mean BP and BPV, as determined by the coefficient of variation of the systolic and diastolic BP, were recorded during a mean of 12 ± 6 outpatient clinic visits. Results: The mean age of the patients was 71 ± 11 years. After a mean of 76 ± 18 month’s follow-up, 161 (26%) patients died, 35% (56/161) were due to cardiovascular causes. 16% and 5% developed recurrent stroke and acute coronary syndrome (ACS), respectively. After adjusting for mean systolic BP and confounding variables, patients with a high systolic BPV were at significantly greater risk of cardiovascular mortality (hazard ratio [HR] = 2.36; 95% confidence interval [CI], 1.02-5.49; P < 0.05). A high systolic BPV also predicted all-cause mortality after adjusting for mean systolic BP (HR = 1.79; 95% CI, 1.16-2.75; P < 0.05). There was no association between systolic BPV with non-fatal recurrent stroke nor non-fatal ACS. A raised diastolic BPV did not predict recurrent non-fatal stroke, non-fatal ACS nor mortality. Conclusions: Visit-to-visit systolic BPV predicts long-term all-cause and cardiovascular mortality in patients with ischaemic stroke without atrial fibrillation, independent of other conventional risk factors including average BP control.
Persistent Identifierhttp://hdl.handle.net/10722/204271
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorLau, GKKen_US
dc.contributor.authorWong, YKen_US
dc.contributor.authorTeo, KCen_US
dc.contributor.authorChang, SKRen_US
dc.contributor.authorChan, KHen_US
dc.contributor.authorHon, FKSen_US
dc.contributor.authorWat, KLen_US
dc.contributor.authorCheung, RTFen_US
dc.contributor.authorLi, LSWen_US
dc.contributor.authorSiu, DCWen_US
dc.contributor.authorHo, SLen_US
dc.contributor.authorTse, HFen_US
dc.date.accessioned2014-09-19T21:43:13Z-
dc.date.available2014-09-19T21:43:13Z-
dc.date.issued2014en_US
dc.identifier.citationThe 19th Medical Research Conference (MRC 2014), Hong Kong, China, 18 January 2014. In Hong Kong Medical Journal, 2014, v. 20 suppl. 1, p. 28, abstract no. 39en_US
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/204271-
dc.description.abstractBackground: Both blood pressure (BP) and its variability (BPV) are established risk factors for the development of atherosclerotic diseases and are associated with an increased risk of cardiovascular and all-cause mortality. The long-term prognostic implications of out-patient clinic visit-to-visit BPV among patients with ischaemic stroke are nevertheless unknown. Methods: We prospectively followed up the clinical outcome of 632 consecutive ischaemic stroke patients without atrial fibrillation. The mean BP and BPV, as determined by the coefficient of variation of the systolic and diastolic BP, were recorded during a mean of 12 ± 6 outpatient clinic visits. Results: The mean age of the patients was 71 ± 11 years. After a mean of 76 ± 18 month’s follow-up, 161 (26%) patients died, 35% (56/161) were due to cardiovascular causes. 16% and 5% developed recurrent stroke and acute coronary syndrome (ACS), respectively. After adjusting for mean systolic BP and confounding variables, patients with a high systolic BPV were at significantly greater risk of cardiovascular mortality (hazard ratio [HR] = 2.36; 95% confidence interval [CI], 1.02-5.49; P < 0.05). A high systolic BPV also predicted all-cause mortality after adjusting for mean systolic BP (HR = 1.79; 95% CI, 1.16-2.75; P < 0.05). There was no association between systolic BPV with non-fatal recurrent stroke nor non-fatal ACS. A raised diastolic BPV did not predict recurrent non-fatal stroke, non-fatal ACS nor mortality. Conclusions: Visit-to-visit systolic BPV predicts long-term all-cause and cardiovascular mortality in patients with ischaemic stroke without atrial fibrillation, independent of other conventional risk factors including average BP control.-
dc.languageengen_US
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk-
dc.relation.ispartofHong Kong Medical Journalen_US
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleLong-term prognostic implications of visit-to-visit blood pressure variability in patients with ischaemic strokeen_US
dc.typeConference_Paperen_US
dc.identifier.emailLau, GKK: gkklau@hku.hken_US
dc.identifier.emailChang, SKR: skrchang@hku.hken_US
dc.identifier.emailChan, KH: koonho@hku.hken_US
dc.identifier.emailCheung, RTF: rtcheung@hku.hken_US
dc.identifier.emailLi, LSW: lswli@hkucc.hku.hken_US
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hken_US
dc.identifier.emailHo, SL: slho@hku.hken_US
dc.identifier.emailTse, HF: hftse@hkucc.hku.hken_US
dc.identifier.authorityLau, GKK=rp01499en_US
dc.identifier.authorityChan, KH=rp00537en_US
dc.identifier.authorityCheung, RTF=rp00434en_US
dc.identifier.authoritySiu, DCW=rp00534en_US
dc.identifier.authorityHo, SL=rp00240en_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturepublished_or_final_version-
dc.identifier.hkuros236289en_US
dc.identifier.volume20en_US
dc.identifier.issuesuppl. 1en_US
dc.identifier.spage28, abstract no. 39en_US
dc.identifier.epage28, abstract no. 39en_US
dc.publisher.placeHong Kong-

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