Abstract
Although blood pressure variability (BPV) and reperfusion are associated with parenchymal hematoma (PH) after stroke, the relationship between BPV and PH in atrial fibrillation (AF) patients who are at risk of reperfusion injury with frequent spontaneous recanalization is unknown. This study aimed to investigate whether BPV within the first 48 h is associated with PH within 72 h in patients with AF and stroke in terms of major vessel occlusion status. A total of 131 patients with AF that were admitted within 24 h after stroke onset were enrolled. PH was defined as a confluent hemorrhage with mass effect. The maximum (max), minimum (min), and average blood pressure (BP) during the first 48 h after admission were calculated. BPV was analyzed by using range between maximum and minimum (max–min), successive variation (SV), standard deviation (SD), and coefficient of variation (CV). All parameters were applied for systemic (SBP), diastolic (DBP), and pulse pressure (PP). After adjusting for confounding variables, various BPV parameters were associated with PH, including SBPmax (p = 0.0426), SBPSV (p = 0.0006), DBPmax-min (p = 0.0437), DBPSV (p = 0.0358), DBPSD (p = 0.0393), PPmax-min (p = 0.0478), PPSV (p < 0.0001), PPSD (p = 0.0034), and PPCV (p = 0.0120). The relationship remained significant in patients with a patent major vessel responsible for infarction but not in patients with an occluded major vessel. In conclusion, this study revealed that high BPV was associated with PH in patients with AF and acute stroke, particularly for those with a patent major vessel. The control of BP and BPV after stroke may be considered in patients with AF.
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Acknowledgements
This study was supported by a grant from the Kaohsiung Medical University Hospital (grant numbers: KMUH111–1M51). The authors thank the help from Dr. Ming-Yen Lin, a biostatistician in the Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University.
Funding
This study was supported by a grant from the Kaohsiung Medical University Hospital (grant numbers: KMUH111–1M51), but this funding source had no involvement of study design, collection, analysis, and interpretation of results, writing of the report or any restrictions regarding submission.
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Wu, MN., Liu, YP., Fong, YO. et al. The impact of blood pressure variability on the development of parenchymal hematoma in acute cerebral infarction with atrial fibrillation. Hypertens Res 47, 618–627 (2024). https://doi.org/10.1038/s41440-023-01479-5
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DOI: https://doi.org/10.1038/s41440-023-01479-5
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