Post-Stroke Pulse Pressure May Hint at Recurrence

Long-term outcomes following ischemic stroke are affected by pulse pressure, especially in patients older than 60 years, according to a recent study.

Currently, not many studies have investigated the effects of pulse pressure, which is a surrogate marker of arterial stiffness, on long-term outcomes in patients with stroke.
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To investigate this potential association further, the researchers evaluated 4195 patients with first-ever ischemic stroke within 3 months of baseline. Mean patient age was 61.2 years.

Baseline blood pressure (BP) was measured and recorded. Endpoints of the study were combined recurrent vascular events and all-cause mortality, as well as recurrent stroke.

Findings from the analysis indicated that systolic BP, diastolic BP, mean arterial pressure, and pulse pressure were not significantly correlated with long-term stroke outcomes in patients younger than 60 years. However, in patients age 60 years or older, pulse pressure was significantly associated with combined recurrent vascular events and all-cause mortality (hazard ratio [HR] 1.35) and recurrent stroke (HR 1.46).

The researchers noted that the combination of systolic BP and pulse pressure, diastolic BP and pulse pressure, or mean arterial pressure and pulse pressure did not indicate any incremental value of systolic BP, diastolic BP, or mean arterial pressure, respectively, in predicting long-term outcomes of stroke.

“[Pulse pressure] was significantly associated with long-term stroke outcomes, and this association was prominent in patients with stroke older than 60 years of age,” the researchers concluded.

—Christina Vogt

Reference:

Su N, Zhai FF, Ni J, et al. Pulse pressure within 3 months after ischemic stroke is associated with long-term stroke outcomes. Am J Hypertens. 2017;30(12):1189-1195. https://doi.org/10.1093/ajh/hpx121.