The Significance of Blood Pressure Variability for the Development of Hemorrhagic Transformation in Acute Ischemic Stroke
- 1 November 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 41 (11), 2512-2518
- https://doi.org/10.1161/strokeaha.110.595561
Abstract
Background and Purpose— Elevated blood pressure (BP) is commonly observed in acute ischemic stroke and is known to be associated with hemorrhagic transformation (HT). However, the effect of BP variability on the development of HT is not known well. Methods— A consecutive series of patients with acute ischemic stroke, who were hospitalized within 24 hours of onset and showed no HT on initial gradient echo MRI, were enrolled in this study. BP measurements during the first 72 hours were obtained, and BP variability of each patient was described using various summary parameters: SD, maximum (max), minimum (min), difference between max and min (max−min), average squared difference between successive measurements (sv), and maximum sv (svmax). Results— Of 792 patients meeting the eligibility criteria, 70 (8.8%) developed HT. Among BP variability parameters categorized into quartiles, SBP max , SBP min , SBP max−min , SBP svmax , DBP SD , DBP max , DBP min , DBP max−min , and DBP svmax were significantly associated with HT independent of mean SBP, age, interval from onset to arrival, initial stroke severity, diabetes mellitus, stroke subtype, thrombolysis, initial glucose, and total cholesterol ( P Conclusions— Our study suggests that we may consider not only the absolute level of BP but also its variability to prevent hemorrhagic transformation.Keywords
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