Relationship between circadian blood pressure rhythms and outcome in diabetic and nondiabetic patients with ischemic stroke

doi:10.3969/j.issn.1006-7795.2016.01.013

Abstract

Abstract: Objective To investigate the association between circadian blood pressure rhythms and cardiovascular outcome in diabetic and nondiabetic patients with ischemic stroke. Methods The 373 ischemic stroke inpatients with large artery atherosclerosis were recruited and followed up at Cerebrovascular Center of Beijing Tiantan Hospital from May 2010 to August 2011. The baseline data were recorded. Ambulatory blood pressure monitoring was performed. The endpoint events included stroke recurrence, vascular events, and cardiovascular death. Results Totally 367 patients were included in the final analysis. The patients were divided into two groups according to the circadian blood pressure pattern: dipper (76 patients) and nondipper group (291 patients). The patients were followed-up for (19.0±5.0) months. The patients in nondipper group showed a higher prevalence of cardiovascular events, higher nocturnal blood pressure (P<0.05). Kaplan-Meier analysis showed that the cardiovascular events-free survival was lower in nondipper group than those in dipper group but did not reach statistical significance (P=0.052). Kaplan-Meier analysis showed that there were no significant differences in cardiovascular events-free survival between dipper and nondipper groups in nondiabetic patients (P=0.763); However, diabetic patients with nondipper showed a less cardiovascular events-free survival (P=0.030). Through Cox regression we found that the age (hazard ratio=1.037, 95%CI: 1.008-1.067, P=0.013), diabetes mellitus (hazard ratio=2.406, 95%CI: 1.340-4.319, P=0.003), modified. Rankin Scale (mRS) on admission (hazard ratio=1.379, 95%CI: 1.143-1.664, P=0.001) and nondipper (hazard ratio=0.964, 95%CI: 0.928-1.001, P=0.056) were associated with cardiovascular outcomes in diabetic patients with stroke. Conclusion Abnormal circadian blood pressure rhythms were associated with cardiovascular outcomes in stroke patients with diabetes, but we did not find a correlation between blood pressure rhythms and cardiovascular outcomes in stroke patients without diabetes.

Key words: stroke, ischemic, diabetes mellitus, circadian blood pressure rhythms, outcome

CLC Number:

R743.3

Tian Junping, Wang Hong, Wang Hongxia, Zhao Xingquan, Chen Buxing. Relationship between circadian blood pressure rhythms and outcome in diabetic and nondiabetic patients with ischemic stroke[J]. Journal of Capital Medical University, 2016, 37(1): 62-69.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2016.01.013

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2016/V37/I1/62

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