Objective To analyze the characteristics of blood pressure variability(BPV) in acute stroke patients,
and to explore the association between BPV and different types of stroke.
Methods A prospective study was conducted among 306 consecutively admitted patients of acute
stroke from the department of Neurology in Beijing Tiantan Hospital during the period from March
2012 to December 2012. Patients were divided into cerebral hemorrhage group and ischemic stroke
(IS) group. The latter was further divided into large artery atherosclerosis(LAA) subgroup and non-
LAA subgroup according to China Ischemic Stroke Subclassification(CISS). Twenty four hour
ambulatory blood pressure monitoring(ABPM) was tested in all the patients, and the index were
recorded, including systolic blood pressure(SBP) (24-hour, day-time and night-time), diastolic
blood pressure(DBP) (24-hour, day-time and night-time), mean blood pressure(MBP) (24-hour, daytime
and night-time), pulse pressure(PP) (24-hour, day-time and night-time), heart rate(HR) (24-hour,day-time and night-time), and modified Rankin Scale(mRS) score. mRS score was recorded when
patients discharged or on the 21st day after their onset. One-way analysis of variance, chi-quare test
and logistic regression were applied to evaluate the differences of the indicators between different
groups, which included general information, past medical history, neurological function, mRS score,
MBP, and indicators of BPV(the standard deviation[SD] and the coefficient of variation[CV] of
SBP, DBP, MBP and PP).
Results A total of 306 cases of acute stroke patients were investigated, including 123 cerebral
hemorrhage cases and 183 cerebral infarction(CI) cases. (1) There was no significant increase in
the value of 24 h-MBP in acute stroke patients. The values of 24 h-DBP, d-DBP(day-time DBP),
n-DBP(night-time DBP) , 24 h-HR, d-HR, n-HR in cerebral hemorrhage group were significantly
higher than those in CI group. Conversely, the value of 24 h-PP, d-PP, n-PP in CI group were
significantly higher than those incerebral hemorrhage group. (2) BPV was significantly different
in cerebral hemorrhage group and ischemic stroke group. P value of the SD of SBP and MBP, the
CV of SBP, DBP and MBP were all below 0.05, which indicated that cerebral infarction patients
hadhigher BPV. However, there were no significant differences of BPV between the two subgroups,
LAA group and non-LAA group. (3) Acute stroke patients hada higher proportion of non-dipper
blood pressure, but there were no statistically significant differences between different types of
stroke, as well as in different subgroups.
Conclusion (1) In this study, we found that the average DBP and the average HR in cerebral
hemorrhage group were higher than those in CI group. Average PP in CI group was higher than
that in cerebral hemorrhage group. There was no significant difference of MBP between the two
subgroups of CI. (2) BPV was significantly different between the cerebral hemorrhage group and
the CI group. The latter had greater BPV. However, there was no significant differences of BPV
between the subtypes of cerebral infarction. (3) Patients with acute stroke has a higher proportion of
non-dipper blood pressure, but when it came to different types of strokeand different subtypes of CI,
the differences were not significant.
