Deans' stroke musings: Higher Blood Pressure Variability, Worse Outcomes Likely in Patients With Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, August 30, 2023

Higher Blood Pressure Variability, Worse Outcomes Likely in Patients With Stroke

We've known of this problem for years! SOLVE IT BY CREATING BLOOD PRESSURE MANAGEMENT PROTOCOLS! Don't just tell us a problem exists, I'd fire anyone who doesn't solve the problem directly in front of them! No excuses!

blood pressure management (68 posts to June 2017)

Higher Blood Pressure Variability, Worse Outcomes Likely in Patients With Stroke

James Maitlall, MD

August 28, 2023

Blood pressure variability was higher and associated with worse outcomes in patients with stroke compared with those without stroke.

Higher blood pressure variations are associated with worse clinical outcomes in patients with stroke compared with those without stroke, according to study findings published in the journal Neurology.

Blood pressure variability has been linked to worse outcomes in patients with stroke and has also been acutely observed in a variety of illnesses. It is unclear whether this variance represents a diseased state, or a modifiable risk factor that can be targeted for intervention. As such, researchers investigated the incidence of blood pressure variability in patients with vs without stroke in an intensive care unit (ICU), as well as comparing outcomes.

The researchers conducted a retrospective analysis on adult patients admitted to the ICU at Beth Israel Deaconess Medical Center (BIDMC) from 2001 and 2012. Data was collected on individuals admitted to the ICU with the following International Classification of Diseases 9th Edition (ICD-9) diagnoses:

ischemic stroke,
intracerebral hemorrhage (ICH),
subarachnoid hemorrhage (SAH),
acute myocardial infarction,
pulmonary embolism, sepsis,
congestive heart failure,
gastrointestinal bleed, or
pneumonia.

To limit outlier readings, those with less than 10 blood pressure measurements were excluded.

Higher BPV was associated with higher odds of in-hospital death and unfavorable discharge destination in stroke patients following adjustment for other markers of critical illness…

The primary outcome of the study was death, occurring either in-hospital or after transfer out of the ICU. Secondary outcomes included favorable discharges, which consisted of discharge to a person’s home, acute rehabilitation, hospice or skilled nursing facility.