Effect Of Blood Pressure Variability On Hemorrhage Expansion In Acute Intracerebral Hemorrhage

BACKGROUND AND PURPOSE:Whether blood pressure variability (BPV) in hyperacute intracerebral hemorrhage (ICH) patients affects hemorrhage expansion (HE) has not been definite. In our study, we investigated the relationship between BPV and HE in hyperacute ICH patients.METHODS:Patients diagnosed acute intracerebral hemorrhage (≤6h) were enrolled. Computed tomography (CT) was performed at baseline and 24 hour. Hematoma was three-dimensional reconstructed and measured volume by 3D Slicer software. HE was defined as an increase in volume of 33% or an absolute change in haematoma volume of 12.5 mL (on repeat CT). Accordingly, blood pressure was meassurement in the non-paretic arm every 30 minutes in the first 24 hours. BPV was quantified by the standard deviation (SD), coefficient of variation (CV), successive variation (SV). The characteristic of circadian rhythm of blood pressure(CRBP) was described by decreasing amplitude at night:dipper (10-20%); over-dipper (≥20%); non-dipper (0-10%); inverted dipper (≤0%). Multiple logistic analyses assessed BPV associations with hemorrhage expansion and Fisher exact probability test assessed the correlation between CRBP and hemorrhage expansion.RESULTS:Of 36 patients recruited,14 (38.9%) had hemorrhage expansion. Five of 8 (63%) patients with hemorrhage expansion showed CT density heterogeneity. The subects with hemorrhage expansion compared with those without hemorrhage expansion in mean systolic blood pressure (150±16.03mmHg vs 143.56±18.53mmHg) and mean diastolic blood pressure (87.12±15.80 mmHg vs 84.92±12.60mmHg) displayed no significant differences(P>0.05).There were not any significant differences in SD, CV and SD of systolic blood pressure variability and diastolic blood pressure variability between the patients with and without hemorrhage expansion (P>0.05).32 (88.9%) patients showed abnormal CRBP and 12 had hemorrhage expansion. Multiple logistic analyses showed systolic blood pressure variability, diastolic blood pressure variability, the mean in either systolic blood pressure or diastolic blood pressure was not significantly associated with hemorrhage expansion (P>0.05). And there was no significant correlation between CRBP and hemorrhage expansion in Fisher exact probability test.CONCLUSIONS:Blood pressure variability is not significantly associated with hemorrhage expansion in hyperacute ICH patients.