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Article: Ambulatory Blood Pressure Profile and Stroke Recurrence

TitleAmbulatory Blood Pressure Profile and Stroke Recurrence
Authors
Keywordsblood pressure
stroke
Issue Date2021
PublisherBMJ Publishing Group: Open Access Journals. The Journal's web site is located at https://svn.bmj.com/
Citation
Stroke and Vascular Neurology, 2021, Epub 2021-01-19 How to Cite?
AbstractObjectives: 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.
Persistent Identifierhttp://hdl.handle.net/10722/295829
ISSN
2020 Impact Factor: 4.081
2020 SCImago Journal Rankings: 1.829
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorXu, J-
dc.contributor.authorJiang, F-
dc.contributor.authorWang, A-
dc.contributor.authorZhi, H-
dc.contributor.authorGao, Y-
dc.contributor.authorTian, J-
dc.contributor.authorMo, J-
dc.contributor.authorChen, Z-
dc.contributor.authorXu, AD-
dc.contributor.authorLuo, B-
dc.contributor.authorHu, B-
dc.contributor.authorZhang, Y-
dc.contributor.authorZhao, X-
dc.contributor.authorWang, Y-
dc.contributor.authorLi, H-
dc.contributor.authorShen, H-
dc.contributor.authorWang, Y-
dc.date.accessioned2021-02-08T08:14:36Z-
dc.date.available2021-02-08T08:14:36Z-
dc.date.issued2021-
dc.identifier.citationStroke and Vascular Neurology, 2021, Epub 2021-01-19-
dc.identifier.issn2059-8688-
dc.identifier.urihttp://hdl.handle.net/10722/295829-
dc.description.abstractObjectives: 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.-
dc.languageeng-
dc.publisherBMJ Publishing Group: Open Access Journals. The Journal's web site is located at https://svn.bmj.com/-
dc.relation.ispartofStroke and Vascular Neurology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectblood pressure-
dc.subjectstroke-
dc.titleAmbulatory Blood Pressure Profile and Stroke Recurrence-
dc.typeArticle-
dc.identifier.emailZhi, H: hzhi@hku.hk-
dc.identifier.emailShen, H: haipeng@hku.hk-
dc.identifier.authorityJiang, F=rp02185-
dc.identifier.authorityShen, H=rp02082-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1136/svn-2020-000526-
dc.identifier.scopuseid_2-s2.0-85099975568-
dc.identifier.hkuros321252-
dc.identifier.volumeEpub 2021-01-19-
dc.identifier.isiWOS:000702449600006-
dc.publisher.placeUnited Kingdom-

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