Effect of early blood pressure variability on the recovery of neurological function after acute ischemic stroke with large vessel occlusion

doi:10.3877/cma.j.issn.1673-9248.2026.03.006

Abstract

Abstract:

Objective

To investigate the association between early blood pressure variability (BPV) and 90-day functional outcome in patients with acute ischemic stroke with large vessel occlusion (AIS-LVO) after mechanical thrombectomy, and to evaluate the predictive value of BPV for 90-day favorable outcome.

Methods

This retrospective study analyzed 100 AIS-LVO patients who underwent mechanical thrombectomy at Beijing Chaoyang Hospital, Capital Medical University from October 2023 to June 2024. Patients were divided into a low-BPV group (n=72) and a high-BPV group (n=28) according to the median BPV within the first 24 hours postoperatively. Demographic and clinical characteristics were compared between groups. The correlations between BPV and the 90-day modified Rankin scale (mRS) score were assessed by Pearson correlation coefficient (r) and Spearman rank correlation coefficient (ρ). Multivariable Logistic regression was used to determine the independent predictive value of BPV for a 90-day favorable outcome (90-day mRS score ≤2). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminative ability of BPV.

Results

BPV showed a significant positive correlation with the 90-day mRS score (r=0.782, ρ=0.719, P＜0.001). Multivariable Logistic regression identified that BPV (OR=0.504, 95%CI: 0.360 – 0.694, P＜0.001) and preoperative National Institutes of Health stroke scale (NIHSS) score (OR=0.950, 95%CI: 0.910 – 0.994, P=0.035) were independent predictors of a favorable outcome at 90 days, with higher BPV showing a significant negative correlation with good prognosis. ROC curve analysis demonstrated that BPV predicted 90-day favorable outcome with an area under the curve (AUC) of 0.865, a sensitivity of 85.7%, and a specificity of 75.0%.

Conclusion

Elevated early BPV after mechanical thrombectomy is closely associated with poor 90-day functional outcome in AIS-LVO patients. BPV can serve as an independent predictor of a favorable prognosis, and early postoperative BPV management may improve long-term neurological recovery.

Key words: Acute ischemic stroke, Blood pressure variability, Mechanical thrombectomy, Functional outcome, Receiver operating characteristic curve

Yunpeng Liu, Jianwen Jia, Jumei Huang, Yang Wang. Effect of early blood pressure variability on the recovery of neurological function after acute ischemic stroke with large vessel occlusion[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2026, 20(03): 274-279.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9248.2026.03.006

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2026/V20/I03/274

Figures/Tables 4

项目	低BPV组（n=72）	高BPV组（n=28）	统计值	P值
年龄（岁， $x ¯$ ±s）	66.50±11.51	71.64±11.51	t=2.004	0.048
男性[例（%）]	48（66.67）	14（50.00）	χ²=1.737	0.189
高血压史[例（%）]	39（54.17）	15（53.57）	χ²=0.004	0.865
BPV（mmHg， $x ¯$ ±s）	12.79±1.75	17.85±1.49	t=13.430	＜0.001
术前NIHSS评分（分， $x ¯$ ±s）	13.33±5.88	18.39±5.48	t=4.060	＜0.001
出血转化率[例（%）]	15（20.83）	12（42.86）	χ²=4.998	0.025
麻醉方式[例（%）]			χ²=0.051	0.887
局部麻醉	65（90.28）	25（89.29）
全身麻醉	7（9.72）	3（10.71）

项目	低BPV组（n=72）	高BPV组（n=28）	统计值	P值
年龄（岁， $x ¯$ ±s）	66.50±11.51	71.64±11.51	t=2.004	0.048
男性[例（%）]	48（66.67）	14（50.00）	χ²=1.737	0.189
高血压史[例（%）]	39（54.17）	15（53.57）	χ²=0.004	0.865
BPV（mmHg， $x ¯$ ±s）	12.79±1.75	17.85±1.49	t=13.430	＜0.001
术前NIHSS评分（分， $x ¯$ ±s）	13.33±5.88	18.39±5.48	t=4.060	＜0.001
出血转化率[例（%）]	15（20.83）	12（42.86）	χ²=4.998	0.025
麻醉方式[例（%）]			χ²=0.051	0.887
局部麻醉	65（90.28）	25（89.29）
全身麻醉	7（9.72）	3（10.71）

项目	低BPV组（n=72）	高BPV组（n=28）	统计值	P值
mRS评分（分， $x ¯$ ±s）	2.70±1.70	4.40±1.30	t=5.364	＜0.001
mRS评分≤2分[例（%）]	43（59.72）	8（28.57）	χ²=7.911	0.005

项目	低BPV组（n=72）	高BPV组（n=28）	统计值	P值
mRS评分（分， $x ¯$ ±s）	2.70±1.70	4.40±1.30	t=5.364	＜0.001
mRS评分≤2分[例（%）]	43（59.72）	8（28.57）	χ²=7.911	0.005

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