Association between nocturnal blood pressure variation and wake-up ischemic stroke |
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| Affiliation: | 1. Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea;2. Department of Nuclear Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea;1. Department of Chemistry, Federal University of Viçosa, Av. P.H. Rolfs, CEP 36570-000 Viçosa, MG, Brazil;2. Department of Chemistry, ICEx, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Campus Pampulha, CEP 31270-901 Belo Horizonte, MG, Brazil;3. Department of Inorganic Chemistry, Fluminense Federal University, Outeiro de São João Batista, s/n, Centro, CEP 24020-141 Niterói, RJ, Brazil;4. São Carlos Physics Institute – USP, Cx. Postal 369, CEP 13560-970 São Carlos, SP, Brazil;5. Chemistry Institute, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, CEP 37130-000, Alfenas, MG, Brazil;1. Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan;2. Department of General Medicine and Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan;1. Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Japan;2. Department of Orthopedic Surgery, University of Tsukuba, Japan |
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| Abstract: | Ischemic stroke during nocturnal sleep, known as wake-up stroke (WUS), has been reported to have more severe symptoms and worse outcomes than non-WUS. However, studies on risk factors for WUS are scarce and the association between nocturnal blood pressure (BP) and WUS is unclear. In this study, we used ambulatory blood pressure monitoring (ABPM) to examine the association between WUS and variation in nocturnal BP. A total of 369 patients with ischemic stroke within one week were consecutively enrolled. ABPM was applied 1–2 weeks after the ictus because of possible reactive increments of BP; antihypertensive medications were delayed until ABPM. Patients were classified into two groups: WUS and non-WUS. Clinical characteristics, including ABPM parameters, were compared. Sixty-seven (18%) patients had WUS. In univariate analysis, patients with WUS had more severe stroke symptoms than patients with non-WUS. There were no differences in clinical characteristics. In addition, ABPM parameters, including nocturnal BP dipping and morning BP surge, were not associated with occurrence of WUS. Patients with WUS had more severe stroke symptoms and worse outcomes than those with non-WUS. Variation in nocturnal BP may not associated with the occurrence of WUS. |
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| Keywords: | Wake-up stroke Ambulatory blood pressure monitoring Nocturnal dipping Morning surge Metabolic syndrome Ischemic stroke |
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