Blood pressure variability and early neurological deterioration in high-risk patients with acute minor stroke or transient ischemic attack

Objective To analyze the relationship between blood pressure (BP) variability (BPV) and early neurological deterioration (END) in high-risk patients with acute minor stroke or transient ischemic attack. Methods Patients with acute minor stroke or transient ischemic attack were consecutively recruited at the Affiliated Hospital of Yangzhou University between May 2017 and May 2019 and divided into two groups according to the presence of END or not. During the first 72 hours, the parameters of BPV such as BPmax, BPmax-min, BPSD, and BPCV were calculated. Results A total of 102 patients were recruited in this study, of whom 27 (26.5%) developed END. Univariate analysis indicated that age, sex, white blood cell count, C reactive protein, and BPV parameters such as SBPmax-min, SBPSD, SBPCV, DBPmax-min, DBPSD, and DBPCV were significantly associated with the development of END (P<0.05). After adjusting the parameters with a P-value< 0.1, logistic regression analysis demonstrated that SBPmax-min (1.026 [1.002-1.050]), SBPSD (1.124 [1.006-1.256]), SBPCV (1.277 [1.068-1.526]), DBPmax-min (1.084 [1.021-1.151]), DBPSD (1.560 [1.166-2.088]), and DBPCV (1.439 [1.154-1.793]) were all independently associated with the development of END in high-risk patients with acute minor stroke or transient ischemic attack. Conclusion Our study indicated that higher in-hospital BPV may increase the risk of END in high-risk patients with acute minor stroke or transient ischemic attack. Key words: Ischemic attack, transient; Minor stroke; Early neurological deterioration; Blood pressure variability