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Reddin C, Murphy R, Hankey GJ, Wang X, Langhorne P, Oveisgharan S, Xavier D, Judge C, Rosengren A, Iversen HK, Czlonkowska A, Lanas F, Oguz A, Ryglewicz D, Wasay M, Smyth A, Yusuf S, O'Donnell M. Blood pressure variability in acute stroke: Risk factors and association with functional outcomes at 1 month. Eur J Neurol 2024; 31:e16314. [PMID: 38738545 DOI: 10.1111/ene.16314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND AND PURPOSE Blood pressure variability, in acute stroke, may be an important modifiable determinant of functional outcome after stroke. In a large international cohort of participants with acute stroke, it was sought to determine the association of blood pressure variability (in the early period of admission) and functional outcomes, and to explore risk factors for increased blood pressure variability. PATIENTS AND METHODS INTERSTROKE is an international case-control study of risk factors for first acute stroke. Blood pressure was recorded at the time of admission, the morning after admission and the time of interview in cases (median time from admission 36.7 h). Multivariable ordinal regression analysis was employed to determine the association of blood pressure variability (standard deviation [SD] and coefficient of variance) with modified Rankin score at 1-month follow-up, and logistic regression was used to identify risk factors for blood pressure variability. RESULTS Amongst 13,206 participants, the mean age was 62.19 ± 13.58 years. When measured by SD, both systolic blood pressure variability (odds ratio 1.13; 95% confidence interval 1.03-1.24 for SD ≥20 mmHg) and diastolic blood pressure variability (odds ratio 1.15; 95% confidence interval 1.04-1.26 for SD ≥10 mmHg) were associated with a significant increase in the odds of poor functional outcome. The highest coefficient of variance category was not associated with a significant increase in risk of higher modified Rankin score at 1 month. Increasing age, female sex, high body mass index, history of hypertension, alcohol use, and high urinary potassium and low urinary sodium excretion were associated with increased blood pressure variability. CONCLUSION Increased blood pressure variability in acute stroke, measured by SD, is associated with an increased risk of poor functional outcome at 1 month. Potentially modifiable risk factors for increased blood pressure variability include low urinary sodium excretion.
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Affiliation(s)
- Catriona Reddin
- HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland
- Wellcome Trust-HRB, Irish Clinical Academic Training, Dublin, Ireland
| | - Robert Murphy
- HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland
| | - Graeme J Hankey
- Perron Institute Chair in Stroke Research, Medical School, University of Western Australia, Perth, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
| | - Xingyu Wang
- Beijing Hypertension League Institute, Beijing, China
| | - Peter Langhorne
- Academic Section of Geriatric Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow, UK
| | - Shahram Oveisgharan
- Rush Alzheimer Disease Research Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis Xavier
- St Johns Medical College, Bangalore, India
- St Johns Research Institute, Bangalore, India
| | - Conor Judge
- HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland
| | - Annika Rosengren
- Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle K Iversen
- Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Fernando Lanas
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Aytekin Oguz
- Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Dumlupinar Mahallesi, Istanbul, Turkey
- Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | | | - Mohammad Wasay
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Andrew Smyth
- HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Martin O'Donnell
- HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
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Sun F, Zhang JY, Zhao LP, Jin Q, Jin C, Wang QX, Xu JT, Yin MJ. Age differences in the impact of dietary salt on metabolism, blood pressure and cognitive function in male rats. Food Funct 2024; 15:689-703. [PMID: 38108607 DOI: 10.1039/d3fo04211a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The influence of salt consumption on physiological processes, especially blood pressure (BP), metabolism, and cognition, remains a topical concern. While guidelines endorse reduced salt diets, there are gaps in understanding the age-specific implications and challenges in adherence. The present study delved into the differential effects of salt intake on young adult and aged male rats over a 12-week period, using control, low-, and high-salt diets. Key metrics, such as BP, cognition, and general parameters, were monitored. Our findings revealed significant age-dependent effects of salt intake on survival rates, body weight, blood sodium, blood glucose, blood lipids, BP, heart rates, and cognition. Notably, young adult rats did not show significant sodium level changes on a high-salt diet, whereas aged rats experienced increased sodium levels even on a normal salt diet. Blood glucose levels decreased significantly in aged rats on a high-salt diet but remained stable in young adults. Aged rats had the highest survival rates on low-salt diets. Low-salt diets led to reduced BP in both age groups, more significantly in young adults. Young adult rats displayed increased BP variability on both high- and low-salt diets, while a decrease in BP variability was exclusive to aged rats on a low-salt diet. There were significant differences across age groups in short-term memory, but not in long-term memory. The study provides a nuanced understanding of the age-dependent physiological effects of salt intake, suggesting the necessity of age-specific guidelines for public health.
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Affiliation(s)
- Fen Sun
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Jin-Yang Zhang
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Lu-Ping Zhao
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Qi Jin
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Chao Jin
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Qiu-Xiang Wang
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Jun-Tao Xu
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Meng-Jia Yin
- College of Basic Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.
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