Clinical relationship between blood pressure variability and poor prognosis in patients with acute cerebral infarction and H-type hypertension

doi:10.3877/cma.j.issn.2095-123X.2023.04.002

Abstract

Abstract:

Objective

To explore the changes of blood pressure variability (BPV) and its relationship with prognosis in patients with acute cerebral infarction (ACI) and H-type hypertension.

Methods

A total of 88 patients with ACI and H-type hypertension admitted to Neurology Department of Rugao People's Hospital were enrolled as H-type hypertension ACI group between March 2021 and March 2022, while 40 patients with ACI and simple hypertension during the same period were enrolled as simple hypertension ACI group. Both groups of patients underwent 24 h blood pressure monitoring, and the BPV parameters of the two groups were recorded and compared. According to scores of modified Rankin scale (mRS) after 3 months of treatment, patients in H-type hypertension ACI group were divided into good prognosis group and poor prognosis group, and the differences in scores of National Institutes of Health stroke scale (NIHSS) between the two groups were compared. The relationship between BPV and prognosis was analyzed.

Results

The 24 h variation coefficient of systolic blood pressure (24 h SCV), variation coefficient of daytime mean systolic blood pressure (dSCV) and variation coefficient of nighttime mean systolic blood pressure (nSCV) in H-type hypertension ACI group were higher than those in simple hypertension ACI group (P<0.05). After 3 months of treatment, scores of NIHSS and mRS in H-type hypertension ACI group were higher than those in simple hypertension ACI group (P<0.05). There were 63 patients with good prognosis and 25 patients with poor prognosis in H-type hypertension ACI group. 24 h SCV, dSCV and nSCV in patients with good prognosis were lower than those with poor prognosis (P<0.05). After 3 months of treatment, NIHSS score in poor prognosis group was higher than that in good prognosis group (P<0.05). 24 h SCV, dSCV and nSCV were positively correlated with mRS score (r=0.247, 0.357, 0.471, 0.378, P<0.05); nSCV was positively correlated with NIHSS score (r=0.266, P<0.05).

Conclusion

The variability of systolic blood pressure increases in patients with ACI and H-type hypertension, which has certain correlation with prognosis and can be applied to predict poor prognosis.

Key words: Blood pressure variability, H-type hypertension, Acute cerebral infarction, Prognosis

Xiulan Xu, Jianjian Zhu. Clinical relationship between blood pressure variability and poor prognosis in patients with acute cerebral infarction and H-type hypertension[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(04): 199-204.

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References 17

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资料	H型高血压ACI组（n=88）	单纯高血压ACI组（n=40）	t/χ²值	P值
年龄（岁，Mean±SD）	52.74±12.33	51.90±11.86	0.361	0.719
性别（男/女）	68/20	27/13	1.373	0.241
高血压分级[例（%）]			0.452	0.798
Ⅰ级	21（23.86）	8（20.00）
Ⅱ级	43（48.86）	19（47.50）
Ⅲ级	24（27.27）	13（32.50）
糖尿病[例（%）]	36（40.91）	15（37.50）	0.133	0.715
高血脂症[例（%）]	47（53.41）	23（57.50）	0.186	0.667
吸烟史[例（%）]	64（72.73）	23（57.50）	2.929	0.087
Hcy（μmol/L，Mean±SD）	16.48±2.41	7.25±1.82	21.575	<0.001

资料	H型高血压ACI组（n=88）	单纯高血压ACI组（n=40）	t/χ²值	P值
年龄（岁，Mean±SD）	52.74±12.33	51.90±11.86	0.361	0.719
性别（男/女）	68/20	27/13	1.373	0.241
高血压分级[例（%）]			0.452	0.798
Ⅰ级	21（23.86）	8（20.00）
Ⅱ级	43（48.86）	19（47.50）
Ⅲ级	24（27.27）	13（32.50）
糖尿病[例（%）]	36（40.91）	15（37.50）	0.133	0.715
高血脂症[例（%）]	47（53.41）	23（57.50）	0.186	0.667
吸烟史[例（%）]	64（72.73）	23（57.50）	2.929	0.087
Hcy（μmol/L，Mean±SD）	16.48±2.41	7.25±1.82	21.575	<0.001

参数	H型高血压ACI组（n=88）	单纯高血压ACI组（n=40）	t值	P值
24 h SBP（mmHg）	156.99±14.73	154.86±18.17	0.702	0.484
24 h DBP（mmHg）	96.65±11.29	95.84±11.67	0.372	0.710
24 h SCV	14.65±3.12	12.59±3.84	3.000	0.002
24 h DCV	18.75±4.15	17.26±5.26	1.733	0.086
dSCV	9.34±1.51	8.54±2.28	2.362	0.020
nSCV	9.45±1.16	7.42±2.59	6.133	<0.001
dDCV	13.74±4.25	12.29±4.57	1.744	0.084
nDCV	11.75±4.67	10.96±5.27	0.852	0.396

参数	H型高血压ACI组（n=88）	单纯高血压ACI组（n=40）	t值	P值
24 h SBP（mmHg）	156.99±14.73	154.86±18.17	0.702	0.484
24 h DBP（mmHg）	96.65±11.29	95.84±11.67	0.372	0.710
24 h SCV	14.65±3.12	12.59±3.84	3.000	0.002
24 h DCV	18.75±4.15	17.26±5.26	1.733	0.086
dSCV	9.34±1.51	8.54±2.28	2.362	0.020
nSCV	9.45±1.16	7.42±2.59	6.133	<0.001
dDCV	13.74±4.25	12.29±4.57	1.744	0.084
nDCV	11.75±4.67	10.96±5.27	0.852	0.396

参数	预后良好亚组（n=63）	预后不良亚组（n=25）	t值	P值
24 h SBP（mmHg）	156.60±15.25	157.97±13.56	0.392	0.696
24 h DBP（mmHg）	96.52±11.21	96.99±11.69	0.175	0.861
24 h SCV	14.15±3.21	15.91±2.49	2.454	0.016
24 h DCV	18.69±3.95	18.92±4.69	0.235	0.815
dSCV	9.12±1.58	9.91±1.15	2.272	0.026
nSCV	9.28±1.12	9.88±1.16	2.260	0.026
dDCV	13.69±4.26	13.85±4.32	0.154	0.878
nDCV	11.69±4.69	11.89±4.71	0.176	0.861

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