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Interarm Blood Pressure Difference is Associated with Early Neurological Deterioration, Poor Short-Term Functional Outcome, and Mortality in Noncardioembolic Stroke Patients

Title
Interarm Blood Pressure Difference is Associated with Early Neurological Deterioration, Poor Short-Term Functional Outcome, and Mortality in Noncardioembolic Stroke Patients
Authors
Chang, YoonkyungKim, JinkwonKim, Min-HoKim, Yong-JaeSong, Tae-Jin
Ewha Authors
김용재송태진
SCOPUS Author ID
김용재scopus; 송태진scopus
Issue Date
2018
Journal Title
JOURNAL OF CLINICAL NEUROLOGY
ISSN
1738-6586JCR Link

2005-5013JCR Link
Citation
JOURNAL OF CLINICAL NEUROLOGY vol. 14, no. 4, pp. 555 - 565
Keywords
interarm blood pressure differencesankle-brachial indexstrokeearly neurological deteriorationfunctional outcomemortality
Publisher
KOREAN NEUROLOGICAL ASSOC
Indexed
SCIE; SCOPUS; KCI WOS
Document Type
Article
Abstract
Background and Purpose Interarm differences in the systolic and diastolic blood pressures (IASBD and IADBD, respectively) are found in various populations, including stroke patients, but their significance for stroke outcomes has rarely been reported. We aimed to determine the associations of IASBD and IADBD with early neurological deterioration (END), functional outcome, and mortality. Methods This study included 1,008 consecutive noncardioembolic cerebral infarction patients who were admitted within 24 hours of onset and had automatic measurements of blood pressures in the bilateral arms. END was assessed within 72 hours of stroke onset according to predefined criteria. A poor functional outcome was defined as a score on the modified Rankin Scale >= 3 at 3 months after the index stroke. All-cause mortality was also investigated during a median follow-up of 24 months. The absolute difference of blood pressure measurements in both arms were used to define IASBD and IADBD. Results END occurred in 15.3% (155/1,008) of the patients. A multivariate analysis including sex, age, and variables for which the p value was <0.1 in a univariate analysis revealed that IASBD >= 10 mm Hg was significantly associated with END [odds ratio (OR)=1.75, 95% CI=1.02-3.011. IADBD >= 10 mm Hg was also related to END (OR=3.11, 95% CI=1.61-5.99). Moreover, having both IASBD >= 10 mm Hg and IADBD >= 10 mm Hg was related to a poor functional outcome (OR=2.67, 95% CI=1.36-5.35) and mortality (hazard ratio=7.67, 95% CI=3.76-12.83) even after adjusting for END. Conclusions This study suggests that an interarm blood pressure difference of >= 10 mm Hg could be a useful indicator for the risks of END, poor functional outcome, and mortality.
DOI
10.3988/jcn.2018.14.4.555
Appears in Collections:
의과대학 > 의학과 > Journal papers
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