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Interarm blood pressure difference and mortality in patients with acute ischemic stroke.

Authors
 Jinkwon Kim  ;  Tae-Jin Song  ;  Dongbeom Song  ;  Hye Sun Lee  ;  Chung Mo Nam  ;  Hyo Suk Nam  ;  Young Dae Kim  ;  Ji Hoe Heo 
Citation
 NEUROLOGY, Vol.80(16) : 1457-1464, 2013 
Journal Title
 NEUROLOGY 
ISSN
 0028-3878 
Issue Date
2013
MeSH
Aged ; Arm/blood supply ; Atherosclerosis/complications ; Atherosclerosis/physiopathology ; Biomarkers ; Blood Pressure/physiology* ; Brain Ischemia/mortality* ; Brain Ischemia/physiopathology* ; Cause of Death ; Cerebrovascular Circulation/physiology ; Coronary Circulation ; Female ; Functional Laterality/physiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prognosis ; Regional Blood Flow/physiology ; Retrospective Studies ; Risk Factors ; Stroke/mortality* ; Stroke/physiopathology* ; Survival Analysis
Keywords
Aged ; Arm/blood supply ; Atherosclerosis/complications ; Atherosclerosis/physiopathology ; Biomarkers ; Blood Pressure/physiology* ; Brain Ischemia/mortality* ; Brain Ischemia/physiopathology* ; Cause of Death ; Cerebrovascular Circulation/physiology ; Coronary Circulation ; Female ; Functional Laterality/physiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prognosis ; Regional Blood Flow/physiology ; Retrospective Studies ; Risk Factors ; Stroke/mortality* ; Stroke/physiopathology* ; Survival Analysis
Abstract
Objective: The objective of this study was to assess the prognostic value of interarm difference of blood pressure (IAD) measured in acute ischemic stroke and to investigate its association with systemic atherosclerosis. Methods: This was a hospital-based retrospective observational study. Survival data and systolic/diastolic IAD were collected in patients with acute ischemic stroke. Systemic atherosclerosis was determined based on coronary CT angiography, transesophageal echocardiography, ankle-brachial index examination, and cerebral angiography covering both intracranial and extracranial cerebral arteries. Results: Of 834 patients, 10.3% had a systolic IAD ≥10 mm Hg, and 6.0% had a diastolic IAD ≥10 mm Hg. During a mean follow-up period of 2.96 ± 0.95 years, 92 patients died (including 68 cardiovascular deaths). In multivariate Cox regression adjusted for cardiovascular risk factors and initial stroke severity, the presence of systolic IAD ≥10 mm Hg was associated with increased risk of all-cause mortality (hazard ratio [HR] 1.97, 95% confidence interval [CI] 1.16–3.35) and cardiovascular mortality (HR 2.49, 95% CI 1.39–4.46). Patients with diastolic IAD ≥10 mm Hg also had increased risk of all-cause mortality (HR 3.43, 95% CI 1.94–6.08) and cardiovascular mortality (HR 3.51, 95% CI 1.83–6.74). The presence of systolic or diastolic IAD ≥10 mm Hg was associated with peripheral artery disease in the lower limbs, but not with atherosclerosis in the cerebral artery, coronary artery, or the aorta. Conclusions: The presence of interarm systolic or diastolic blood pressure difference ≥10 mm Hg is a strong independent prognostic marker in acute ischemic stroke.
Full Text
http://www.neurology.org/content/80/16/1457.long
DOI
10.1212/WNL.0b013e31828cf87c
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Song, Dong Beom(송동범)
Song, Tae Jin(송태진)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86697
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