Background Elevated blood pressure variability (BPV) has been linked to worsened outcomes in stroke survivors.
Aims: We aimed to investigate the association between systolic and diastolic BPV and post-stroke cognitive impairment (PSCI) in patients with acute cardioembolic stroke.
Methods: Using prospective stroke registry data, we consecutively enrolled 143 participants with acute cardioembolic stroke whose cognitive functions were evaluated 3 months after stroke. Their cognition was assessed with the Korean version of the Vascular Cognitive Impairment Harmonization Standards. PSCI was defined as a z-score of <-2 standard deviations for age, sex, and education-adjusted means in at least one cognitive domain. The association between acute stage blood pressure variability within 7 days during admission and PSCI was assessed using multiple logistic regression, adjusting for age, sex, education, vascular risk factors, initial stroke severity, and neuroimaging characteristics.
Results: Among 143 participants (Mean age 70 years; male 60.1%; median initial NIHSS 5), PSCI was identified in 67 (46.9%) patients. The standard deviation of both systolic and diastolic blood pressure were significant predictors for PSCI (aOR, 1.09; 95% CI, 1.01–1.17 and aOR 1.14; 95% CI, 1.01-1.29, respectively). The mean value of SBP and DBP was also significantly associated with PSCI.
Conclusions: Our findings demonstrate that both systolic and diastolic BPV in the acute phase of cardioembolic ischemic stroke are independently associated with PSCI at three months. These findings highlight the importance of monitoring and managing blood pressure variability in the acute stroke setting to mitigate the risk of cognitive decline potentially.