Original Article
Long-Term Prognostic Implications of Visit-to-Visit Blood Pressure Variability in Patients With Ischemic Stroke Kui-Kai Lau,1 Yuen-Kwun Wong,1 Kay-Cheong Teo,1 Richard S.K. Chang,1 Koon-Ho Chan,1 Sonny F.K. Hon,1 Ka-Lung Wat,2 Raymond T.F. Cheung,1 Leonard S.W. Li,3 Chung-Wah Siu,2 and Hung-Fat Tse2
methods We prospectively followed up the clinical outcome of 632 consecutive ischemic stroke patients without atrial fibrillation. The average BP and BPV, as determined by the coefficient of variation of the systolic and diastolic BP, were recorded during a mean 12 ± 6 outpatient clinic visits. results The average age of the population was 71 ± 11 years. After a mean of 76 ± 18 months of follow-up, 161 patients died (26%); 35% (n = 56 of 161) of these deaths were due to cardiovascular causes. Sixteen percent and 5% developed recurrent stroke and acute coronary syndrome (ACS),
High visit-to-visit blood pressure variability (BPV) is a novel risk factor for the development of stroke and coronary artery disease (CAD) and is associated with an increased risk of cardiovascular and all-cause mortality.1–6 Recently, our group demonstrated that, among patients with ischemic stroke due to small-vessel occlusion, those with high visitto-visit systolic BPV were at significantly increased risk of developing subsequent all-cause and cardiovascular mortality, independent of mean blood pressure (BP) and conventional risk factors of atherosclerosis.7 In this extended study, we sought to investigate the long-term prognostic implications of outpatient clinic visit-to-visit BPV in patients with ischemic stroke of all subtypes without atrial fibrillation. Determinants of BPV in patients with ischemic stroke were also investigated.
Correspondence: Hung-Fat Tse ([email protected]). Initially submitted December 3, 2013; date of first revision December 18, 2013; accepted for publication March 12, 2014; online publication May 18, 2014.
respectively. After adjusting for mean systolic BP and confounding variables, patients with high systolic BPV were at significantly greater risk of cardiovascular mortality (hazards ratio (HR) = 2.36; 95% confidence interval (CI) = 1.02–5.49; P
Long-Term Prognostic Implications of Visit-to-Visit Blood Pressure Variability in Patients With Ischemic Stroke Kui-Kai Lau,1 Yuen-Kwun Wong,1 Kay-Cheong Teo,1 Richard S.K. Chang,1 Koon-Ho Chan,1 Sonny F.K. Hon,1 Ka-Lung Wat,2 Raymond T.F. Cheung,1 Leonard S.W. Li,3 Chung-Wah Siu,2 and Hung-Fat Tse2
methods We prospectively followed up the clinical outcome of 632 consecutive ischemic stroke patients without atrial fibrillation. The average BP and BPV, as determined by the coefficient of variation of the systolic and diastolic BP, were recorded during a mean 12 ± 6 outpatient clinic visits. results The average age of the population was 71 ± 11 years. After a mean of 76 ± 18 months of follow-up, 161 patients died (26%); 35% (n = 56 of 161) of these deaths were due to cardiovascular causes. Sixteen percent and 5% developed recurrent stroke and acute coronary syndrome (ACS),
High visit-to-visit blood pressure variability (BPV) is a novel risk factor for the development of stroke and coronary artery disease (CAD) and is associated with an increased risk of cardiovascular and all-cause mortality.1–6 Recently, our group demonstrated that, among patients with ischemic stroke due to small-vessel occlusion, those with high visitto-visit systolic BPV were at significantly increased risk of developing subsequent all-cause and cardiovascular mortality, independent of mean blood pressure (BP) and conventional risk factors of atherosclerosis.7 In this extended study, we sought to investigate the long-term prognostic implications of outpatient clinic visit-to-visit BPV in patients with ischemic stroke of all subtypes without atrial fibrillation. Determinants of BPV in patients with ischemic stroke were also investigated.
Correspondence: Hung-Fat Tse ([email protected]). Initially submitted December 3, 2013; date of first revision December 18, 2013; accepted for publication March 12, 2014; online publication May 18, 2014.
respectively. After adjusting for mean systolic BP and confounding variables, patients with high systolic BPV were at significantly greater risk of cardiovascular mortality (hazards ratio (HR) = 2.36; 95% confidence interval (CI) = 1.02–5.49; P
