The Significance of Blood Pressure Variability for the Development of Hemorrhagic Transformation in Acute Ischemic Stroke

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. A consecutive series of patients with acute ischemic stroke, who were hospi...

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Bibliographic Details
Published in:Stroke (1970) 2010-11, Vol.41 (11), p.2512-2518
Main Authors: KO, Youngchai, JUNG HYUN PARK, MI HWA YANG, KO, Sang-Bae, HAN, Moon-Ku, CHANG WAN OH, LEE, Jisung, LEE, Juneyoung, BAE, Hee-Joon
Format: Article
Language:English
Subjects:
Aged
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure - physiology
Blood. Blood coagulation. Reticuloendothelial system
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Diastole - physiology
Female
Follow-Up Studies
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Hypertension - complications
Hypertension - physiopathology
Intracranial Hemorrhages - epidemiology
Male
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Pharmacology. Drug treatments
Retrospective Studies
Risk Factors
Stroke - physiopathology
Systole - physiology
Time Factors
Vascular diseases and vascular malformations of the nervous system
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Summary: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. 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). 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
ISSN:0039-2499
1524-4628
1524-4628
DOI:10.1161/strokeaha.110.595561