The Influencing Factors Of Blood Pressure Variability In Patients With Acute Cerebral Infarction And Its Relationship With Prognosis

Objective: To discuss the influencing factors of bloodpressure variability and the relationship between blood pressurevariability and prognosis for3and6months after stroke onset. Methods:The consecutive patients with acute cerebral infarction in the NeurologyDepartment of Sichuan Provincal People’s Hospital from January1,2012to September31,2012were registered prospectively. Previous history ofpatients, and blood pressure variability (BPV) measurements (24hourssystemic blood pressure standard deviation and24hours diastolic bloodpressure standard deviation) were documented to explore the influencingfactors of BPV. We followed up the patients by telephone or in out-patientdepartment at the time of3months and6months after stroke onset. TheModified Rankin Scale (MRS) was used to assess prognosis. Based ondomestic standards, MRS≤2was represented independence, The MRS>2was represented dependence. MRS=6was represented death.Measurement data were expressed as Mean±SD or median. Differencesamong groups were analyzed by Student T test when the dates metnormal distribution. If the dates met non-normal distribution, rank sumtest were used. Qualitative data were described as percentages andanalyzed using Chi-square (χ2) test.1. The factors which might beimpacted BPV were analyzed by a multivariate logistic regression analysis if univariate analyses shown P<0.05to confirm the independentinfluencing factors.2. The factors which might be impacted prognosis inacute ischemic stroke were analyzed by a multivariate logistic regressionanalysis if univariate analyses shown P<0.05to confirm the independentinfluencing factors, and to discuss whether the BPV had an influence onprognosis. Result:254consecutive patients aged30-98years old werediscussed. Included male175(68.8%), female79(31.1%), average age66.93±10.43years old,22(8.66%) patiens died in hospital,6(10.23%)patients died at the time of3months follow-up,29(11.42%) patients diedat the time of6months follow-up,91(35.82%) patients death/dependenceat the time of3months follow-up,79(31.1%) patients death/dependenceat the time of6months follow-up. Through multivariate logisticregression analysis, we found that:1. hypertension (OR3.207,95%CI1.739-5.914), diabetes(OR2.074,95%CI1.103-3.899),sex(OR2.778,95%CI1.429-5.339), age(OR1.069,95%CI1.033-1.107)were the independent influencing factors of24hSBP SD.2. Hypertension(OR2.048,95%CI1.198-3.501), male (OR1.819,95%CI1.007-3.286),smoking (OR1.845,95%CI1.002-3.396) were the independentinfluencing factors of24hDBP SD.3. The NIHSS was the independentinfluencing factor of death at the time of hospitalization,3and6monthsafter patient’s symptom onset. The OR values and95%confidenceinterval were as follows respectively (OR2.01,95%CI1.416-2.853), (OR1.476,95%CI1.255-1.713),(OR1.345,95%CI1.212-1.491). TheBPV was not the independent influence factors of death.4.24hDBP SD(OR1.268,95%CI1.03-1.562), diabetes (OR2.434,95%CI1.201-4.933),NIHSS (OR1.207,95%CI1.143-1.275) were the independent influencingfactors of prognosis at the time of3months follow-up.5.24hDBP SD(OR1.232,95%CI1.000-1.518), NIHSS (OR1.122,95%CI1.155-1.292),diabetes (OR2.17,95%CI1.043-4.516) were the independent influencingfactors of prognosis at the time of6months follow-up. Conclusion:1.The independent influencing factors for BPV in patients with acutecerebral infarction were the history of hypertension, diabetes, smoking,male and age. Aggressive control of blood pressure, glucose and give upsmoking can reduce the abnormal BPV, which may improve theprognosis.2.24hDBP SD could become one of the indicators for judgingthe prognosis of patients with acute cerebral infarction. The higher of24hDBP SD, the worse of the prognosis for patients with acute cerebralinfarction.