Blood Pressure Variability and Shifting in Clinical Outcome Amongst Stroke Patients in Southwestern Uganda

Authors

  • Nicholas Kulaba Mbarara University of science and Technology
  • Adrian Kayanja
  • Denis Serubiri
  • Sophia Najjingo
  • Mark KadduMukasa
  • Shirley M. Moore
  • O’Carroll Cumara B.
  • Anthony Muyingo

Keywords:

Blood pressure variability, Stroke, outcomes, cerebral infarction, intracerebral hemorrhage, Sub-Saharan Africa

Abstract

Background: Higher blood pressure variability has detrimental effects on clinical outcome after a stroke yet it’s has not been well evaluated in Sub-Saharan Africa (SSA). Methods: We conducted a prospective cohort study of CT head confirmed ischemic and hemorrhagic stroke admitted within 7 days of onset of motor weakness. Blood Pressure Variability (BPV) indice; Standard Deviation (SD) of systolic and diastolic Blood pressure (BP) between 0 and 7 days after admission was calculated with subsequent modified Rankin Scale (mRS) score on day 14  and day 30 post-stroke. Ordinal logistic regression was fitted to determine the adjusted odds ratios (aOR) for shifting towards worse clinical outcome among patients with stroke that had survived beyond 14 days with 95% CI and p value<0.05 used as statistical significance. Results: Out of 120 patients, 32 patients passed on by day 14, 88 patients survived beyond day 14. Fifty eight and 15 patients had a zero and 1 point shift in MRS towards worse outcome respectively. Blood pressure variability SD systolic BP tertiles (2&3) had aOR: 1.6, p= 0.306 (95%C.I: 0.6-4.1) and 5.8, p = 0.002 (95%C.I: 1.9-17.5) respectively. NIHSS≥16 had aOR=3.8 (95%CI: 1.5-9.6) P=0.004 and time to presentation ≥ 3 days had aOR=2.8 (95% C.I:1.2-6.3) p=0.013. Conclusion: Higher BPV (tertile 3), late presentation ≥ 3 days and high NIHSS conferred statistically significant odds of shifting towards a bad functional outcome.

Key words:  Blood pressure variability; Stroke; outcomes; cerebral infarction; intracerebral hemorrhage; Sub-Saharan Africa

 

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Published

30-01-2024

How to Cite

1.
Kulaba N, Kayanja A, Serubiri D, Najjingo S, KadduMukasa M, Moore SM, et al. Blood Pressure Variability and Shifting in Clinical Outcome Amongst Stroke Patients in Southwestern Uganda. EAJNS [Internet]. 2024 Jan. 30 [cited 2024 Jun. 13];3(1):9-16. Available from: https://theeajns.org/index.php/eajns/article/view/215

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