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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >High Morning and Bedtime Home Blood Pressures Strongly Predict for Post-Stroke Cognitive Impairment
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High Morning and Bedtime Home Blood Pressures Strongly Predict for Post-Stroke Cognitive Impairment

机译：早晨和就寝时间的家庭血压强烈预测中风后认知障碍

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Background: Hypertension may be the most modifiable risk factor for post-stroke cognitive impairment (PSCI). We investigated how home blood pressure (HBP) can predict PSCI as well as stroke recurrence. Methods: We studied 249 consecutive patients with noncardioembolic minor ischemic stroke including single lacunar infarct (sLI), multiple lacunae (mLI), and atherothrombotic infarction, which were tracked at our outpatient clinic. HBP was measured in the early morning (mHBP) and just before going to bed (b-HBP). HBP categories based on systolic blood pressure were created as follows: HB1, both m-HBP and b-HBP less than 135 (mmHg); HB2, m-HBP less than or equal to 135 and b-HBP less than 135; HB3, m-HBP less than 135 and b-HBP less than or equal to 135; HB4, both m-HBP and b-HBP less than or equal to 135. After 4.1 years of tracking, the patients were divided into 4 groups: Group 1, good outcome (n = 188); Group 2, the development of silent infarcts (n = 16); Group 3, the development of PSCI (n = 33); and Group 4, stroke recurrence (n = 15). Results: HB2 and HB4 (versus HB1) (hazard ratio [HR]: 6.5, P = .0068 and HR: 9.5, P = .0008, respectively) and mLI (versus sLI) (HR: 4.0, P = .021) were independently associated with Group 2. HB3 and HB4 (HR: 4.2, P = .037; HR: 5.4, P <.0001) and mLI (HR: 6.4, P <.0001) were significantly associated with Group 3. HB4 (HR: 8.1, P = .0002) and mLI (HR: 10.2, P = .0003) were significantly associated with Group 4. Clinic blood pressure (BP) was not significantly associated with any adverse groups. Conclusions: High HBP and mLI were strongly associated with PSCI as well as stroke recurrence. BP should be monitored based on HBP, especially bedtime HBP, for the prevention of PSCI.
机译：背景：高血压可能是中风后认知障碍（PSCI）的最可改变的危险因素。我们调查了家庭血压（HBP）如何预测PSCI以及中风复发。方法：我们对门诊门诊连续追踪的249例非心脏栓塞性轻度缺血性卒中患者进行了研究，包括单腔隙性梗塞（sLI），多处腔隙（mLI）和动脉粥样硬化性梗塞。在清晨（mHBP）和临睡前（b-HBP）测量HBP。创建基于收缩压的HBP类别如下：HB1，m-HBP和b-HBP均小于135（mmHg）; HB2，m-HBP小于或等于135，b-HBP小于135; HB3，m-HBP小于135，b-HBP小于或等于135; HB4，m-HBP和b-HBP均小于或等于135。经过4.1年的追踪，将患者分为4组：第1组，好转归（n = 188）;第1组为好转。第二组，无声梗死的发展（n = 16）;第三组，PSCI的发展（n = 33）;第4组，卒中复发（n = 15）。结果：HB2和HB4（相对HB1）（危险比[HR]：6.5，P = .0068和HR：9.5，P = .0008）和mLI（相对于sLI）（HR：4.0，P = .021）与第2组独立相关。HB3和HB4（HR：4.2，P = .037; HR：5.4，P <.0001）和mLI（HR：6.4，P <.0001）与第3组显着相关。 HR：8.1，P = .0002）和mLI（HR：10.2，P = .0003）与第4组显着相关。临床血压（BP）与任何不良组均无显着相关。结论：高HBP和mLI与PSCI以及中风复发密切相关。应基于HBP（尤其是就寝时间的HBP）监测BP，以预防PSCI。

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