Midterm Blood Pressure Variability Is Associated with Poststroke Cognitive Impairment: A Prospective Cohort Study

ObjectiveThe aim of this study was to investigate the relationship between blood pressure variability (BPV) and poststroke cognitive impairment (PSCI).MethodsSeven-hundred ninety-six patients with acute ischemic stroke were included in this study. Midterm BPV was evaluated by calculating the SD and...

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Main Authors: Shan Geng, Na Liu, Pin Meng, Niu Ji, Yong’an Sun, Yingda Xu, Guanghui Zhang, Xiaobing He, Zenglin Cai, Bei Wang, Bei Xu, Zaipo Li, Xiaoqin Niu, Yongjin Zhang, Bingchao Xu, Xinyu Zhou, Mingli He
Format: Article
Language:English
Published: Frontiers Media S.A. 2017-07-01
Series:Frontiers in Neurology
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Online Access:http://journal.frontiersin.org/article/10.3389/fneur.2017.00365/full
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Summary:ObjectiveThe aim of this study was to investigate the relationship between blood pressure variability (BPV) and poststroke cognitive impairment (PSCI).MethodsSeven-hundred ninety-six patients with acute ischemic stroke were included in this study. Midterm BPV was evaluated by calculating the SD and coefficient of variation (CV, 100 × SD/mean) of systolic blood pressure (SBP) and diastolic blood pressure during the 7 days after stroke onset. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at admission and at all follow-up visits. Patients with MoCA scores <26 were considered to have PSCI.ResultsThe incidence of PSCI reached its peak (72%) 3 months after stroke onset and decreased to 30.3% at 12 months poststroke. After adjusting for covariables, the increase in the prevalence of PSCI at 3 months was independently associated with increases in the CV of blood pressure during the 7 days after stroke [odds ratios and 95% CI for patients in the second to fifth quintiles of SBP CV were 2.28 (1.18, 4.39), 2.33 (1.18, 4.62), 2.69 (1.31, 5.53), and 4.76 (1.95, 11.67), respectively]. Sub-analysis of the MoCA scores revealed that the patients had impairments in visuoperceptual abilities and executive functions, as well as in naming and delayed recall (p < 0.05).ConclusionMidterm BPV during the early phase of acute ischemic stroke is independently associated with PSCI, especially in the visuoperceptual, executive, and delayed recall domains.Clinical Trial Registrationhttp://www.chictr.org.cn, identifier ChiCTR-TRC-14004804.
ISSN:1664-2295