Hemodynamic changes in progressive cerebral infarction: An observational study based on blood pressure monitoring

Ling Li, Bin Wu, Jiaoxuan Dong, Songbin He, Jie Xu, Gary Tse, Fangyu Dai, Haipeng Liu

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Abstract

Progressive cerebral infarction (PCI) is a common complication in patients with ischemic stroke that leads to poor prognosis. Blood pressure (BP) can indicate post‐stroke hemodynamic changes which play a key role in the development of PCI. The authors aim to investigate the association between BP‐derived hemodynamic parameters and PCI. Clinical data and BP recordings were collected from 80 patients with cerebral infarction, including 40 patients with PCI and 40 patients with non‐progressive cerebral infarction (NPCI). Hemodynamic parameters were calculated from the BP recordings of the first 7 days after admission, including systolic and diastolic BP, mean arterial pressure, and pulse pressure (PP), with the mean values of each group calculated and compared between daytime and nighttime, and between different days. Hemodynamic parameters and circadian BP rhythm patterns were compared between PCI and NPCI groups using t‐test or non‐parametric equivalent for continuous variables, Chi‐squared test or Fisher's exact test for categorical variables, Cox proportional hazards regression analysis and binary logistic regression analysis for potential risk factors. In PCI and NPCI groups, significant decrease of daytime systolic BP appeared on the second and sixth days, respectively. Systolic BP and fibrinogen at admission, daytime systolic BP of the first day, nighttime systolic BP of the third day, PP, and the ratio of abnormal BP circadian rhythms were all higher in the PCI group. PCI and NPCI groups were significantly different in BP circadian rhythm pattern. PCI is associated with higher systolic BP, PP and more abnormal circadian rhythms of BP.
Original languageEnglish
Pages (from-to)122-133
Number of pages12
JournalThe Journal of Clinical Hypertension
Volume26
Issue number2
Early online date8 Jan 2024
DOIs
Publication statusE-pub ahead of print - 8 Jan 2024

Bibliographical note

© 2023 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Funder

The authors would like to thank the radiology department for their help. This research was funded by Medical and Health Science and Technology Plan Project of Zhoushan and Medical Health Science and Technology Project of Zhejiang Provincial Health Commission, grant number 2021YA07, 2022KY1367.

Keywords

  • stroke
  • hemodynamic parameters
  • blood pressure (BP)
  • progressive cerebral infarction (PCI)

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