Pulse Pressure Within 3 Months After Ischemic Stroke Is Associated With Long-Term Stroke Outcomes

Am J Hypertens. 2017 Nov 6;30(12):1189-1195. doi: 10.1093/ajh/hpx121.

Abstract

Background: Pulse pressure (PP) is a surrogate marker of arterial stiffness. Studies on baseline PP and long-term outcomes in patients with stroke are limited. We aimed to evaluate whether PP within 3 months after ischemic stroke was associated with long-term stroke outcomes.

Methods: A total of 4,195 patients (61.2 ± 11.6 years, 68.4% men) with first-ever ischemic stroke in 3 months had baseline blood pressure (BP) measured. Study end-points were the combined end-points (recurrent vascular events and all-cause mortality) and recurrent stroke.

Results: In the group <60 years of age, the BP components of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), or PP did not significantly correlate with long-term stroke outcomes. In the group ≥60 years of age, PP was significantly associated with combined end-points (hazards ratio [HR] = 1.35; 95% confidence interval [CI], 1.18-1.54) and recurrent stroke (HR = 1.46; 95% CI, 1.24-1.72). Combination of SBP and PP, DBP and PP, or MAP and PP, respectively, showed no incremental value of SBP, DBP, or MAP in predicting long-term stroke outcomes.

Conclusions: PP was significantly associated with long-term stroke outcomes, and this association was prominent in patients with stroke older than 60 years of age.

Keywords: blood pressure; hypertension; ischemic stroke; long-term outcome; pulse pressure.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Arterial Pressure
  • Blood Pressure*
  • Brain Ischemia / mortality
  • Brain Ischemia / physiopathology*
  • Cohort Studies
  • Endpoint Determination
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Stroke / mortality
  • Stroke / physiopathology*
  • Treatment Outcome
  • Vascular Stiffness