# Correlation between blood pressure variability and prognosis of endovascular therapy in ischemic stroke due to middle cerebral artery occlusion

## TL;DR

This study found that higher blood pressure variability after stroke treatment is linked to worse outcomes, but the results may not be reliable due to the small sample size.

## Contribution

The study identifies blood pressure variability as a potential predictor of poor outcomes after endovascular therapy for stroke.

## Key findings

- Higher systolic and pulse pressure variability were associated with poor 90-day outcomes after stroke treatment.
- Multivariable analysis showed systolic and pulse pressure variability independently predicted poor prognosis.
- The study suggests blood pressure variability may reflect stroke severity rather than being a causal factor.

## Abstract

To evaluate the impact of post-endovascular therapy (EVT) systolic, diastolic, and pulse pressure (PP) variability on 3 month functional outcomes in patients with middle cerebral artery occlusion.

Patients were classified as having good (mRS 0–2) or poor (mRS 3–6) 90 day outcomes. We compared 48 h postoperative BP parameters and BPV indices (SD, CV, and ARV). Multivariable logistic regression adjusted for age, baseline NIHSS, hypertension, atrial fibrillation, and pre-stroke mRS was used to examine associations between BPV and outcome.

The average real variability of systolic blood pressure (SBPARV: 10.08 vs. 7.89, p < 0.001), diastolic blood pressure (DBPARV: 8.42 vs. 7.87, p = 0.006), and PP (PPARV: 11.00 vs. 8.26, p < 0.001) were significantly higher in the poor prognosis group than in the good prognosis group. Multivariable logistic regression showed that SBPARV (OR = 2.619, 95% CI 1.606–4.271; p < 0.001) and PPARV (PPARV: 11.00 vs. 8.26, p < 0.001) were independently associated with poor prognosis at 3 months.

In this retrospective cohort, higher postoperative SBP ARV and PP ARV were independently associated with poor 90 day functional outcome after EVT; however, given the small sample size and observational design, the predictive value of BPV parameters is likely limited. BPV may be an epiphenomenon of more severe stroke rather than a causal determinant or clinically actionable target.