FOLLOWUS
Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
Received:27 February 2023,
Accepted:2023-5-16,
Published Online:07 June 2023,
Published:30 September 2023
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Ke-Qiong Yan, Qi-Si Wu, Jun Yang. Blood Pressure Variability May Be a New Predictor for the Occurrence and Prognosis of Ischemic Stroke[J]. Chinese medical sciences journal, 2023, 38(3): 242-249.
Ke-Qiong Yan, Qi-Si Wu, Jun Yang. Blood Pressure Variability May Be a New Predictor for the Occurrence and Prognosis of Ischemic Stroke[J]. Chinese medical sciences journal, 2023, 38(3): 242-249. DOI: 10.24920/004219.
尽管近年来发病率和死亡率有所下降,但缺血性脑卒中(ischemic stroke
IS)仍然是脑血管疾病致死、致残的主要原因之一。干预可控性危险因素是临床管理IS的基础。高血压是IS最常见的可治疗危险因素之一,并与不良结局有关。动态血压监测结果显示高血压患者的血压变异性(blood pressure variability
BPV)高于非高血压患者。同时,BPV升高已被证明是IS的危险因素。BPV越高,IS发生的风险越高,卒中后的预后越差,无论是在急性期还是亚急性期。BPV受多因素影响,其变化反映了个体的生理病理改变。本文综述了目前BPV与IS关系的研究进展,旨在提高临床医生和IS患者对BPV的认识,探讨BPV升高是IS的可控危险因素。对于高血压患者,不仅需要控制血压平均水平,同时需要关注血压变异性,以更好地开展个性化血压管理。
Despite declines in morbidity and mortality in recent years
ischemic stroke (IS) remains one of the leading causes of death and disability from cerebrovascular diseases. Addressing the controllable risk factors underpins the successful clinical management of IS. Hypertension is one of the most common treatable risk factors for IS and is associated with poor outcomes. Ambulatory blood pressure monitoring has revealed that patients with hypertension have a higher incidence of blood pressure variability (BPV) than those without hypertension. Meanwhile
increased BPV has been identified as a risk factor for IS. The risk of IS is higher and the prognosis after infarction is worse with higher BPV
no matter in the acute or subacute phase. BPV is multifactorial
with alterations reflecting individual physiological and pathological changes. This article reviews the current research advances in the relationship between BPV and IS
with an attempt to raise awareness of BPV among clinicians and IS patients
explore the increased BPV as a controllable risk factor for IS
and encourage hypertensive patients to control not only average blood pressure but also BPV and implement personalized blood pressure management.
Johnson CO , Nguyen M , Roth GA , et al . Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 . The Lancet Neurology 2019 ; 18 ( 5 ): 439 - 58 . doi: 10.1016/s1474-4422(19)30034-1 https://dx.doi.org/10.1016/s1474-4422(19)30034-1 . https://linkinghub.elsevier.com/retrieve/pii/S1474442219300341 https://linkinghub.elsevier.com/retrieve/pii/S1474442219300341
Feigin VL , Abajobir AA , Abate KH , et al . Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 . The Lancet Neurology 2017 ; 16 ( 11 ): 877 - 97 . doi: 10.1016/s1474-4422(17)30299-5 https://dx.doi.org/10.1016/s1474-4422(17)30299-5 . https://linkinghub.elsevier.com/retrieve/pii/S1474442217302995 https://linkinghub.elsevier.com/retrieve/pii/S1474442217302995
Campbell BCV , De Silva DA , Macleod MR , et al . Ischaemic stroke . Nat Rev Dis Primers 2019 ; 5 ( 1 ): 70 . doi: 10.1038/s41572-019-0118-8 https://dx.doi.org/10.1038/s41572-019-0118-8 .
Kuriakose D , Xiao Z . Pathophysiology and treatment of stroke: present status and future perspectives . Int J Mol Sci 2020 ; 21 ( 20 ): doi: 10.3390/ijms21207609 https://dx.doi.org/10.3390/ijms21207609 .
Putaala J . Ischemic Stroke in Young Adults . Continuum (Minneap Minn) 2020 ; 26 ( 2 ): 386 - 414 . doi: 10.1212/CON.0000000000000833 https://dx.doi.org/10.1212/CON.0000000000000833 .
Liu L , Chen W , Zhou H , et al . Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of ischaemic cerebrovascular diseases . Stroke Vasc Neurol 2020 ; 5 ( 2 ): 159 - 76 . doi: 10.1136/svn-2020-000378 https://dx.doi.org/10.1136/svn-2020-000378 .
Xu T , Zhang Y , Bu X , et al . Blood pressure reduction in acute ischemic stroke according to time to treatment: a subgroup analysis of the China Antihypertensive Trial in Acute Ischemic Stroke trial . J Hypertens 2017 ; 35 ( 6 ): 1244 - 51 . doi: 10.1097/HJH.0000000000001288 https://dx.doi.org/10.1097/HJH.0000000000001288 .
Turin TC , Okamura T , Afzal AR , et al . Hypertension and lifetime risk of stroke . J Hypertens 2016 ; 34 ( 1 ): 116 - 22 . doi: 10.1097/HJH.0000000000000753 https://dx.doi.org/10.1097/HJH.0000000000000753 .
Lattanzi S , Brigo F , Silvestrini M . Blood pressure variability and stroke: A risk marker of outcome and target for intervention . J Clin Hypertens (Greenwich) 2021 ; 23 ( 1 ): 103 - 5 . doi: 10.1111/jch.14092 https://dx.doi.org/10.1111/jch.14092 .
Xu J , Liu Y , Wang A , et al . Blood pressure fluctuation pattern and stroke outcomes in acute ischemic stroke . Hypertens Res 2019 ; 42 ( 11 ): 1776 - 82 . doi: 10.1038/s41440-019-0292-9 https://dx.doi.org/10.1038/s41440-019-0292-9 .
Toyoda K , Yamagami H , Kitagawa K , et al . Blood pressure level and variability during long-term prasugrel or clopidogrel medication after stroke: PRASTRO-I . Stroke 2021 ; 52 ( 4 ): 1234 - 43 . doi: 10.1161/STROKEAHA.120.032824 https://dx.doi.org/10.1161/STROKEAHA.120.032824 .
Webb AJS , Mazzucco S , Li L , et al . Prognostic significance of blood pressure variability on beat-to-beat monitoring after transient ischemic atack and stroke . Stroke 2018 ; 49 ( 1 ): 62 - 7 . doi: 10.1161/STROKEAHA.117.019107 https://dx.doi.org/10.1161/STROKEAHA.117.019107 . https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.019107 https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.019107
Parati G , Ochoa JE , Lombardi C , et al . Blood pressure variability: assessment, predictive value, and potential as a therapeutic target . Curr Hypertens Rep 2015 ; 17 ( 4 ): 537 . doi: 10.1007/s11906-015-0537-1 https://dx.doi.org/10.1007/s11906-015-0537-1 .
Wang R , Liu Y , Yang P , et al . Blood pressure fluctuation during hospitalization and clinical outcomes within 3 months after ischemic stroke . Hypertension 2022 ; 79 ( 10 ): 2336 - 45 . doi: 10.1161/HYPERTENSIONAHA.122.19629 https://dx.doi.org/10.1161/HYPERTENSIONAHA.122.19629 . https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.122.19629 https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.122.19629
Appiah KO , Nath M , Manning L , et al . Increasing blood pressure variability predicts poor functional outcome following acute stroke . J Stroke Cerebrovasc Dis 2021 ; 30 ( 1 ): 105466 . doi: 10.1016/j.jstrokecerebrovasdis.2020.105466 https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105466 . https://linkinghub.elsevier.com/retrieve/pii/S1052305720308843 https://linkinghub.elsevier.com/retrieve/pii/S1052305720308843
Sugiura T , Takase H , Machii M , et al . Blood pressure variability and the development of hypertensive organ damage in the general population . J Clin Hypertens (Greenwich) 2022 ; 24 ( 11 ): 1405 - 14 . doi: 10.1111/jch.14526 https://dx.doi.org/10.1111/jch.14526 .
Bencivenga L , De Souto Barreto P , Rolland Y , et al . Blood pressure variability: a potential marker of aging . Ageing Res Rev 2022 ; 80 101677. doi: 10.1016/j.arr.2022.101677 https://dx.doi.org/10.1016/j.arr.2022.101677 .
Parati G , Stergiou GS , Dolan E , et al . Blood pressure variability: clinical relevance and application . J Clin Hypertens (Greenwich) 2018 ; 20 ( 7 ): 1133 - 7 . doi: 10.1111/jch.13304 https://dx.doi.org/10.1111/jch.13304 .
Hernandez MF , Chang TI . The need to reduce variability in the study of blood pressure variability . Am J Kidney Dis 2023 ; 81 ( 4 ): 379 - 81 . doi: 10.1053/j.ajkd.2022.10.008 https://dx.doi.org/10.1053/j.ajkd.2022.10.008 .
Chi XL , Wang XY , Guo ZR , et al . Relationships between blood pressure variability and silent cerebral infarction in patients with primary hypertension . Artery Res 2018 ; 24 40 - 6 . doi: 10.1016/j.artres.2018.11.001 https://dx.doi.org/10.1016/j.artres.2018.11.001 . https://www.atlantis-press.com/article/125924850 https://www.atlantis-press.com/article/125924850
Haverkamp RA , Melis RJF , Claassen J , et al . Day-to-day home blood pressure variability and all-cause mortality in a memory clinic population . J Alzheimers Dis 2022 ; 85 ( 3 ): 1219 - 31 . doi: 10.3233/JAD-215002 https://dx.doi.org/10.3233/JAD-215002 . https://www.medra.org/servlet/aliasResolver?alias=iospress&doi=10.3233/JAD-215002 https://www.medra.org/servlet/aliasResolver?alias=iospress&doi=10.3233/JAD-215002
Hisamatsu T , Ohkubo T . Home blood pressure variability and target organ damage . Hypertens Res 2022 ; 45 ( 3 ): 543 - 5 . doi: 10.1038/s41440-021-00844-6 https://dx.doi.org/10.1038/s41440-021-00844-6 .
Chen Y , Xiong H , Wu D , et al . Relationship of short-term blood pressure variability with carotid intima-media thickness in hypertensive patients . Biomed Eng Online 2015 ; 14 : 71 . doi: 10.1186/s12938-015-0059-8 https://dx.doi.org/10.1186/s12938-015-0059-8 .
Tatasciore A , Di Nicola M , Tommasi R , et al . From short-term blood pressure variability to atherosclerosis: relative roles of vascular stiffness and endothelial dysfunction . J Clin Hypertens (Greenwich) 2020 ; 22 ( 7 ): 1218 - 27 . doi: 10.1111/jch.13871 https://dx.doi.org/10.1111/jch.13871 . https://onlinelibrary.wiley.com/toc/17517176/22/7 https://onlinelibrary.wiley.com/toc/17517176/22/7
Hisamatsu T , Miura K , Ohkubo T , et al . Home blood pressure variability and subclinical atherosclerosis in multiple vascular beds: a population-based study . J Hypertens 2018 ; 36 ( 11 ): 2193 - 203 . doi: 10.1097/HJH.0000000000001810 https://dx.doi.org/10.1097/HJH.0000000000001810 .
Gironacci MM , Cerniello FM , Longo Carbajosa NA , et al . Protective axis of the renin-angiotensin system in the brain . Clin Sci (Lond) 2014 ; 127 ( 5 ): 295 - 306 . doi: 10.1042/CS20130450 https://dx.doi.org/10.1042/CS20130450 .
Miao CY , Su DF . The importance of blood pressure variability in rat aortic and left ventricular hypertrophy produced by sinoaortic denervation . J Hypertens 2002 ; 20 ( 9 ): 1865 - 72 . doi: 10.1097/00004872-200209000-00033 https://dx.doi.org/10.1097/00004872-200209000-00033 . http://journals.lww.com/00004872-200209000-00033 http://journals.lww.com/00004872-200209000-00033
Miao CY , Zhang LM , Yuan WJ , et al . Angiotensin Ⅱ and AT1 receptor in hypertrophied ventricles and aortas of sinoaortic-denervated rats . Acta Pharmacol Sin 2003 ; 24 ( 8 ): 812 - 8 .
Wu L , Iwai M , Nakagami H , et al . Roles of angiotensin Ⅱ type 2 receptor stimulation associated with selective angiotensin Ⅱ type 1 receptor blockade with valsartan in the improvement of inflammation-induced vascular injury . Circulation 2001 ; 104 ( 22 ): 2716 - 21 . doi: 10.1161/hc4601.099404 https://dx.doi.org/10.1161/hc4601.099404 .
Schiffrin EL , Touyz RM . From bedside to bench to bedside: role of renin-angiotensin-aldosterone system in remodeling of resistance arteries in hypertension . Am J Physiol Heart Circ Physiol 2004 ; 287 ( 2 ): H435 - 46 . doi: 10.1152/ajpheart.00262.2004 https://dx.doi.org/10.1152/ajpheart.00262.2004 . http://www.physiology.org/doi/10.1152/ajpheart.00262.2004 http://www.physiology.org/doi/10.1152/ajpheart.00262.2004
Inaba S , Iwai M , Tomono Y , et al . Exaggeration of focal cerebral ischemia in transgenic mice carrying human Renin and human angiotensinogen genes . Stroke 2009 ; 40 ( 2 ): 597 - 603 . doi: 10.1161/STROKEAHA.108.519801 https://dx.doi.org/10.1161/STROKEAHA.108.519801 .
Zhang C , Chen H , Xie HH , et al . Inflammation is involved in the organ damage induced by sinoaortic denervation in rats . J Hypertens 2003 ; 21 ( 11 ): 2141 - 8 . doi: 10.1097/00004872-200311000-00024 https://dx.doi.org/10.1097/00004872-200311000-00024 .
Hickey JV , Salmeron ET , Lai JM . Twenty-four-hour blood pressure variability after acute ischemic stroke . Crit Care Nurs Q 2002 ; 25 ( 2 ): 1 - 12 ; quiz 74 - 15 . doi: 10.1097/00002727-200208000-00002 https://dx.doi.org/10.1097/00002727-200208000-00002 .
Rothwell PM , Howard SC , Dolan E , et al . Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension . Lancet 2010 ; 375 ( 9718 ): 895 - 905 . doi: 10.1016/S0140-6736(10)60308-X https://dx.doi.org/10.1016/S0140-6736(10)60308-X .
Gosmanova EO , Mikkelsen MK , Molnar MZ , et al . Association of systolic blood pressure variability with mortality, coronary heart disease, stroke, and renal disease . J Am Coll Cardiol 2016 ; 68 ( 13 ): 1375 - 86 . doi: 10.1016/j.jacc.2016.06.054 https://dx.doi.org/10.1016/j.jacc.2016.06.054 .
Wang H , Li M , Xie SH , et al . Visit-to-visit systolic blood pressure variability and stroke risk: a systematic review and meta-analysis . Curr Med Sci 2019 ; 39 ( 5 ): 741 - 7 . doi: 10.1007/s11596-019-2100-9 https://dx.doi.org/10.1007/s11596-019-2100-9 .
Chen YK , Ni ZX , Li W , et al . Diurnal blood pressure and heart rate variability in hypertensive patients with cerebral small vessel disease: a case-control study . J Stroke Cerebrovasc Dis 2021 ; 30 ( 5 ): 105673 . doi: 10.1016/j.jstrokecerebrovasdis.2021.105673 https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105673 . https://linkinghub.elsevier.com/retrieve/pii/S1052305721000768 https://linkinghub.elsevier.com/retrieve/pii/S1052305721000768
Kario K , Shimada K . Risers and extreme-dippers of nocturnal blood pressure in hypertension: antihypertensive strategy for nocturnal blood pressure . Clin Exp Hypertens 2004 ; 26 ( 2 ): 177 - 89 . doi: 10.1081/ceh-120028556 https://dx.doi.org/10.1081/ceh-120028556 .
Gasecki D , Kwarciany M , Kowalczyk K , et al . Blood pressure management in acute ischemic stroke . Curr Hypertens Rep 2020 ; 23 ( 1 ): 3 . doi: 10.1007/s11906-020-01120-7 https://dx.doi.org/10.1007/s11906-020-01120-7 .
Akhtar N , Al-Jerdi S , Kamran S , et al . Night-time non-dipping blood pressure and heart rate: an association with the risk of silent small vessel disease in patients presenting with acute ischemic stroke . Front Neurol 2021 ; 12 719311 . doi: 10.3389/fneur.2021.719311 https://dx.doi.org/10.3389/fneur.2021.719311 . https://www.frontiersin.org/articles/10.3389/fneur.2021.719311/full https://www.frontiersin.org/articles/10.3389/fneur.2021.719311/full
Yan B , Peng L , Dong Q , et al . Reverse-dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension . Eur J Neurol 2015 ; 22 ( 6 ): 1022 - 5 . doi: 10.1111/ene.12659 https://dx.doi.org/10.1111/ene.12659 .
Zhang Q , Zhou B , Ma Y , et al . Blood pressure visit-to-visit variability and outcomes in patients with heart failure with preserved ejection fraction . ESC Heart Fail 2021 ; 8 ( 5 ): 3984 - 96 . doi: 10.1002/ehf2.13542 https://dx.doi.org/10.1002/ehf2.13542 .
Rothwell PM . Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension . Lancet 2010 ; 375 ( 9718 ): 938 - 48 . doi: 10.1016/S0140-6736(10)60309-1 https://dx.doi.org/10.1016/S0140-6736(10)60309-1 .
Hata Y , Kimura Y , Muratani H , et al . Office blood pressure variability as a predictor of brain infarction in elderly hypertensive patients . Hypertens Res 2000 ; 23 ( 6 ): 553 - 60 . doi: 10.1291/hypres.23.553 https://dx.doi.org/10.1291/hypres.23.553 .
Kikuya M , Ohkubo T , Metoki H , et al . Day-by-day variability of blood pressure and heart rate at home as a novel predictor of prognosis: the Ohasama study . Hypertension 2008 ; 52 ( 6 ): 1045 - 50 . doi: 10.1161/HYPERTENSIONAHA.107.104620 https://dx.doi.org/10.1161/HYPERTENSIONAHA.107.104620 .
Johansson JK , Niiranen TJ , Puukka PJ , et al . Prognostic value of the variability in home-measured blood pressure and heart rate: the Finn-Home Study . Hypertension 2012 ; 59 ( 2 ): 212 - 8 . doi: 10.1161/HYPERTENSIONAHA.111.178657 https://dx.doi.org/10.1161/HYPERTENSIONAHA.111.178657 .
Dicker D , Maya I , Vasilevsky V , et al . Blood pressure variability in acute ischemic stroke depends on hemispheric stroke location . Blood Press 2006 ; 15 ( 3 ): 151 - 6 . doi: 10.1080/08037050600772755 https://dx.doi.org/10.1080/08037050600772755 . http://www.tandfonline.com/doi/full/10.1080/08037050600772755 http://www.tandfonline.com/doi/full/10.1080/08037050600772755
Lundholm MD , Rooney M , Maas MB , et al . Wake-up stroke is associated with greater nocturnal mean arterial pressure variability . Stroke 2017 ; 48 ( 6 ): 1668 - 70 . doi: 10.1161/STROKEAHA.116.016202 https://dx.doi.org/10.1161/STROKEAHA.116.016202 .
Kitamura J , Ueno H , Nagai M , et al . Blood pressure variability in acute ischemic stroke: influence of infarct location in the insular cortex . Eur Neurol 2018 ; 79 ( 1-2 ): 90 - 9 . doi: 10.1159/000486306 https://dx.doi.org/10.1159/000486306 .
Kimura K , Minematsu K , Yonemura K , et al . Hypertension and neurovascular compression of the left lateral medulla oblongata in ischemic stroke . Eur Neurol 2001 ; 46 ( 2 ): 70 - 4 . doi: 10.1159/000050766 https://dx.doi.org/10.1159/000050766 .
Ciriello J , Caverson MM , Polosa C . Function of the ventrolateral medulla in the control of the circulation . Brain Res 1986 ; 396 ( 4 ): 359 - 91 . doi: 10.1016/0165-0173(86)90005-6 https://dx.doi.org/10.1016/0165-0173(86)90005-6 .
Han SW , Kim SH , Lee JY , et al . A new subtype classification of ischemic stroke based on treatment and etiologic mechanism . Eur Neurol 2007 ; 57 ( 2 ): 96 - 102 . doi: 10.1159/000098059 https://dx.doi.org/10.1159/000098059 .
Gao S , Wang YJ , Xu AD , et al. Chinese ischemic stroke subclassification . Front Neurol 2011 ; 2 : 6 . doi: 10.3389/fneur.2011.00006 https://dx.doi.org/10.3389/fneur.2011.00006 .
Muntner P , Whittle J , Lynch AI , et al . Visit-to-visit variability of blood pressure and coronary heart disease, stroke, heart failure, and mortality: a cohort study . Ann Intern Med 2015 ; 163 ( 5 ): 329 - 38 . doi: 10.7326/M14-2803 https://dx.doi.org/10.7326/M14-2803 .
Diaz KM , Veerabhadrappa P , Kashem MA , et al . Relationship of visit-to-visit and ambulatory blood pressure variability to vascular function in African Americans . Hypertens Res 2012 ; 35 ( 1 ): 55 - 61 . doi: 10.1038/hr.2011.135 https://dx.doi.org/10.1038/hr.2011.135 .
Malik EZ , Abdulhadi B , Mezue KN , et al. Clinical hypertension: blood pressure variability . Dis Mon 2018 ; 64 ( 1 ): 5 - 13 . doi: 10.1016/j.disamonth.2017.08.003 https://dx.doi.org/10.1016/j.disamonth.2017.08.003 .
Lorenz MW , Markus HS , Bots ML , et al . Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis . Circulation 2007 ; 115 ( 4 ): 459 - 67 . doi: 10.1161/CIRCULATIONAHA.106.628875 https://dx.doi.org/10.1161/CIRCULATIONAHA.106.628875 .
Heshmatollah A , Ma Y , Fani L , et al . Visit-to-visit blood pressure variability and the risk of stroke in the Netherlands: a population-based cohort study . PLoS Med 2022 ; 19 ( 3 ): e1003942 . doi: 10.1371/journal.pmed.1003942 https://dx.doi.org/10.1371/journal.pmed.1003942 . https://dx.plos.org/10.1371/journal.pmed.1003942 https://dx.plos.org/10.1371/journal.pmed.1003942
Lee SR , Choi YJ , Choi EK , et al . Blood pressure variability and incidence of new-onset atrial fibrillation: a nationwide population-based study . Hypertension 2020 ; 75 ( 2 ): 309 - 15 . doi: 10.1161/HYPERTENSIONAHA.119.13708 https://dx.doi.org/10.1161/HYPERTENSIONAHA.119.13708 . https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13708 https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13708
Olbers J , Gille A , Ljungman P , et al . High beat-to-beat blood pressure variability in atrial fibrillation compared to sinus rhythm . Blood Press 2018 ; 27 ( 5 ): 249 - 55 . doi: 10.1080/08037051.2018.1436400 https://dx.doi.org/10.1080/08037051.2018.1436400 . https://www.tandfonline.com/doi/full/10.1080/08037051.2018.1436400 https://www.tandfonline.com/doi/full/10.1080/08037051.2018.1436400
Minhas JS , Wang X , Lavados PM , et al . Blood pressure variability and outcome in acute ischemic and hemorrhagic stroke: a post hoc analysis of the HeadPoST study . J Hum Hypertens 2019 ; 33 ( 5 ): 411 - 8 . doi: 10.1038/s41371-019-0193-z https://dx.doi.org/10.1038/s41371-019-0193-z .
Kang J , Kim BJ , Yang MH , et al . Blood pressure variability in subacute stage and risk of major vascular events in ischemic stroke survivors . J Hypertens 2019 ; 37 ( 10 ): 2000 - 6 . doi: 10.1097/HJH.0000000000002126 https://dx.doi.org/10.1097/HJH.0000000000002126 .
Appiah KOB , Patel M , Panerai RB , et al . Increased blood pressure variability following acute stroke is associated with poor long-term outcomes: a systematic review . Blood Press Monit 2019 ; 24 ( 2 ): 67 - 73 . doi: 10.1097/MBP.0000000000000366 https://dx.doi.org/10.1097/MBP.0000000000000366 .
Chung JW , Kim N , Kang J , et al . Blood pressure variability and the development of early neurological deterioration following acute ischemic stroke . J Hypertens 2015 ; 33 ( 10 ): 2099 - 106 . doi: 10.1097/HJH.0000000000000675 https://dx.doi.org/10.1097/HJH.0000000000000675 . https://journals.lww.com/00004872-201510000-00020 https://journals.lww.com/00004872-201510000-00020
Dai L , Cheng A , Hao X , et al . Different contribution of SBP and DBP variability to vascular events in patients with stroke . Stroke Vasc Neurol 2020 ; 5 ( 2 ): 110 - 5 . doi: 10.1136/svn-2019-000278 https://dx.doi.org/10.1136/svn-2019-000278 .
Naito H , Hosomi N , Kuzume D , et al . Increased blood pressure variability during the subacute phase of ischemic stroke is associated with poor functional outcomes at 3 months. Sci Rep 2020 ; 10 ( 1 ): 811 . doi: 10.1038/s41598-020-57661-z https://dx.doi.org/10.1038/s41598-020-57661-z .
Zhang Y , Wang H , Xu K , et al . Ambulatory blood pressure variability within the first 24 hours after admission and outcomes of acute ischemic stroke . J Am Soc Hypertens 2018 ; 12 ( 3 ): 195 - 203 . doi: 10.1016/j.jash.2017.12.012 https://dx.doi.org/10.1016/j.jash.2017.12.012 .
Martins AI , Sargento-Freitas J , Jesus-Ribeiro J , et al . Blood pressure variability in acute ischemic stroke: the role of early recanalization . Eur Neurol 2018 ; 80 ( 1-2 ): 63 - 7 . doi: 10.1159/000492627 https://dx.doi.org/10.1159/000492627 .
Geng X , Liu X , Li F , et al . Blood pressure variability at different time periods within first 24 hours after admission and outcomes of acute ischemic stroke . J Clin Hypertens (Greenwich) 2020 ; 22 ( 2 ): 194 - 204 . doi: 10.1111/jch.13785 https://dx.doi.org/10.1111/jch.13785 .
de Havenon A , Stoddard G , Saini M , et al . Increased blood pressure variability after acute ischemic stroke increases the risk of death: a secondary analysis of the Virtual International Stroke Trial Archive . JRSM Cardiovasc Dis 2019 ; 8 : 2048004019856496. doi: 10.1177/2048004019856496 https://dx.doi.org/10.1177/2048004019856496 .
Manning LS , Rothwell PM , Potter JF , et al . Prognostic significance of short-term blood pressure variability in acute stroke: systematic review . Stroke 2015 ; 46 ( 9 ): 2482 - 90 . doi: 10.1161/STROKEAHA.115.010075 https://dx.doi.org/10.1161/STROKEAHA.115.010075 .
Tang S , Xiong L , Fan Y , et al . Stroke outcome prediction by blood pressure variability, heart rate variability, and baroreflex sensitivity . Stroke 2020 ; 51 ( 4 ): 1317 - 20 . doi: 10.1161/STROKEAHA.119.027981 https://dx.doi.org/10.1161/STROKEAHA.119.027981 .
Kamieniarz-Medrygal M , Lukomski T , Kazmierski R . Short-term outcome after ischemic stroke and 24-h blood pressure variability: association and predictors . Hypertens Res 2021 ; 44 ( 2 ): 188 - 96 . doi: 10.1038/s41440-020-00534-9 https://dx.doi.org/10.1038/s41440-020-00534-9 .
Yong M , Diener HC , Kaste M , et al . Characteristics of blood pressure profiles as predictors of long-term outcome after acute ischemic stroke . Stroke 2005 ; 36 ( 12 ): 2619 - 25 . doi: 10.1161/01.STR.0000189998.74892.24 https://dx.doi.org/10.1161/01.STR.0000189998.74892.24 .
Yamamoto Y , Akiguchi I , Oiwa K , et al . Adverse effect of nighttime blood pressure on the outcome of lacunar infarct patients . Stroke 1998 ; 29 ( 3 ): 570 - 6 . doi: 10.1161/01.str.29.3.570 https://dx.doi.org/10.1161/01.str.29.3.570 .
Dai L , Song L , Li X , et al . Association of visit-to-visit blood pressure variability with the risk of all-cause mortality and cardiovascular events in general population . J Clin Hypertens (Greenwich) 2018 ; 20 ( 2 ): 280 - 8 . doi: 10.1111/jch.13192 https://dx.doi.org/10.1111/jch.13192 .
Fukuda K , Kai H , Kamouchi M , et al . Day-by-day blood pressure variability and functional outcome after acute ischemic stroke: fukuoka stroke registry . Stroke 2015 ; 46 ( 7 ): 1832 - 9 . doi: 10.1161/STROKEAHA.115.009076 https://dx.doi.org/10.1161/STROKEAHA.115.009076 .
Yang C , Liu K , Song Y , et al . Day-by-day blood pressure variability is associated with neurological functional outcome after acute ischemic stroke . Front Neurol 2020 ; 11 566825 . doi: 10.3389/fneur.2020.566825 https://dx.doi.org/10.3389/fneur.2020.566825 . https://www.frontiersin.org/articles/10.3389/fneur.2020.566825/full https://www.frontiersin.org/articles/10.3389/fneur.2020.566825/full
Ko Y , Park JH , Yang MH , et al . The significance of blood pressure variability for the development of hemorrhagic transformation in acute ischemic stroke . Stroke 2010 ; 41 ( 11 ): 2512 - 8 . doi: 10.1161/STROKEAHA.110.595561 https://dx.doi.org/10.1161/STROKEAHA.110.595561 .
Kim TJ , Park HK , Kim JM , et al . Blood pressure variability and hemorrhagic transformation in patients with successful recanalization after endovascular recanalization therapy: a retrospective observational study . Ann Neurol 2019 ; 85 ( 4 ): 574 - 81 . doi: 10.1002/ana.25434 https://dx.doi.org/10.1002/ana.25434 .
Liu K , Yan S , Zhang S , et al . Systolic blood pressure variability is associated with severe hemorrhagic transformation in the early stage after thrombolysis . Transl Stroke Res 2016 ; 7 ( 3 ): 186 - 91 . doi: 10.1007/s12975-016-0458-6 https://dx.doi.org/10.1007/s12975-016-0458-6 .
Delgado-Mederos R , Ribo M , Rovira A , et al . Prognostic significance of blood pressure variability after thrombolysis in acute stroke . Neurology 2008 ; 71 ( 8 ): 552 - 8 . doi: 10.1212/01.wnl.0000318294.36223.69 https://dx.doi.org/10.1212/01.wnl.0000318294.36223.69 .
Powers WJ , Rabinstein AA , Ackerson T , et al . Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association . Stroke 2019 ; 50 ( 12 ): e344 - e418 . doi: 10.1161/STR.0000000000000211 https://dx.doi.org/10.1161/STR.0000000000000211 .
Rouch L , Cestac P , Sallerin B , et al . Visit-to-visit blood pressure variability is associated with cognitive decline and incident dementia: the S.AGES cohort . Hypertension 2020 ; 76 ( 4 ): 1280 - 8 . doi: 10.1161/HYPERTENSIONAHA.119.14553 https://dx.doi.org/10.1161/HYPERTENSIONAHA.119.14553 .
Bohm M , Schumacher H , Leong D , et al . Systolic blood pressure variation and mean heart rate is associated with cognitive dysfunction in patients with high cardiovascular risk . Hypertension 2015 ; 65 ( 3 ): 651 - 61 . doi: 10.1161/HYPERTENSIONAHA.114.04568 https://dx.doi.org/10.1161/HYPERTENSIONAHA.114.04568 .
Kim Y , Lim JS , Oh MS , et al . Blood pressure variability is related to faster cognitive decline in ischemic stroke patients: PICASSO subanalysis . Sci Rep 2021 ; 11 ( 1 ): 5049 . doi: 10.1038/s41598-021-83945-z https://dx.doi.org/10.1038/s41598-021-83945-z .
Hilkens NA , Klijn CJM , Richard E . Blood pressure, blood pressure variability and the risk of poststroke dementia . J Hypertens 2021 ; 39 ( 9 ): 1859 - 64 . doi: 10.1097/HJH.0000000000002841 https://dx.doi.org/10.1097/HJH.0000000000002841 .
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