Abstract 15874: Effect of Blood Pressure During the Acute Phase on 3-month and 2-year Clinical Outcomes Among Patients With Ischemic Stroke
We studied the effect of systolic blood pressure (SBP, mean and variability) during the acute phase on 3-month and 2-year major clinical outcomes in patients with ischemic stroke. The China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) recruited 4,071 patients with acute ischemic stroke and elevated SBP from 26 hospitals in China. Three BPs were measured every 2 hours for the first 24 hours (hyperacute phase), every 4 hours during the second and third days, and every 8 hours thereafter for the remainder of the seven days (acute phase). Mean and standard deviation (SD) of SBP were calculated from BP measures at 12 time-points in the first 24 hours and 24 time-points during days 2-7, separately. Logistic regression, Cox proportional hazards regression, and spline analyses were used to examine the associations between SBP and clinical outcomes stratified by intervention groups. Mean, but not variability of, SBP was consistently associated with clinical outcomes. For example, the multiple-adjusted odds ratio (95% CI) of death or major disability associated with a one SD change in SBP within 24-hours was 1.21 (1.08 to 1.34, p=0.0006) in the intervention group and 1.30 (1.16 to 1.45, p<0.0001) in the control group. Likewise, the multiple-adjusted odds ratio (95% CI) of death or major disability associated with a one SD change in SBP during days 2-7 was 1.17 (1.05 to 1.30, p=0.005) in the intervention group and 1.30 (1.16 to 1.45, p<0.0001) in the control group. SBP variability in the hyperacute or acute phase was not significantly associated with death and major disability (all P>0.27). Spline analyses showed U-shaped associations between mean SBP in the acute phase and risk of death and major disability at 3 months or 2 years in the intervention group, with an optimal SBP level of 130-140 mm Hg. Our study indicated that mean SBP, but not its variability, during the acute phase was associated with risk of death and major disability among patients with ischemic stroke.
Author Disclosures: C. Li: None. Y. Zhang: None. T. Xu: None. X. Bu: None. H. Peng: None. J. Chen: None. J. He: None.
- © 2016 by American Heart Association, Inc.