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Prognostic value of beat-to-beat blood pressure variability parameters in patients after mechanical thrombectomy

Hypertension Research volume 48, pages 1155–1162 (2025)Cite this article

Abstract

The relationship of beat-to-beat blood pressure variability (BPV) with prognosis after mechanical thrombectomy (MT) is unclear. Consecutive patients with acute ischemic stroke with large vessel occlusion treated with and without MT matched 1:1 by age, sex, and National Institutes of Health Stroke Scale were included. Beat-to-beat BPV was calculated for both systolic (SBP) and diastolic blood pressure (DBP) as standard deviation, coefficient of variation, successive variation (SV), and average real variability (ARV) at 24–72 h after MT. Additionally, hour-to-hour (first 24 h after MT) and day-by-day BPV (first 7 days after MT) were also measured. The outcome was modified Rankin Scale (mRS) at 3 months. Of 168 patients, 84 patients received MT and 84 did not. MT closely correlated with lower beat-to-beat BPV parameters. Beat-to-beat SBP-SV and SBP-ARV were significantly higher in patients with unfavorable outcome than in those with favorable outcome (median 3.40 vs 2.71; P = 0.016; median 2.81 vs 2.20, P = 0.003). After adjusting for confounders, higher beat-to-beat SBP-SV and SBP-ARV were independently associated with unfavorable outcome in patients with MT (all P < 0.05). However, no association was found between hour-to-hour and day-by-day BPV and outcome at 3 months (P > 0.05). The patients with MT had lower beat-to-beat BPV values in the acute phase, which indicated that MT has a positive effect on beat-to-beat BPV. Furthermore, beat-to-beat BPV, rather than hour-to-hour or day-by-day BPV, is an independent risk factor for unfavorable outcome in patients after MT.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank the patients and their families and appreciate the study participants for their assistance in this study.

Funding

This project was supported by the National Natural Science Foundation of China (823B2025) to YYS, the National Natural Science Foundation of China (Grant No. 81971105), the Science and Technology Department of Jilin Province (YDZJ202201ZYTS677), and Norman Bethune Program of Jilin University (2022B02) to ZNG, and the Norman Bethune Health Science Center of Jilin University (2022JBGS03), Science and Technology Department of Jilin Province (YDZJ202302CXJD061, 20220303002SF), and Jilin Provincial Key Laboratory (YDZJ202302CXJD017) to YY, and Graduate Innovation Fund of Jilin University (2023CX113) to YQ.

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  1. These authors contributed equally: Ying-Ying Sun, Shu-Yan Pang

Authors and Affiliations

  1. Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China

    Ying-Ying Sun, Shu-Yan Pang, Yang Qu, Si-Ji Wang, Hong-Jing Zhu, Wen-Jing Yin, Yi Yang & Zhen-Ni Guo

  2. Neuroscience Research Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China

    Zhen-Ni Guo

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  1. Ying-Ying Sun
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Contributions

All authors fulfill the criteria for authorship set by the International Committee of Medical Journal Editors. YY and ZNG were responsible for conceptualization. Y-YS, S-YP, YQ, and S-JW performed data collection. Y-YS, H-JZ, YQ, and W-JY performed data analysis and interpretation. The first draft of the manuscript was written by Y-YS and all authors contributed to the article and approved the submitted version.

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Correspondence to Yi Yang or Zhen-Ni Guo.

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The authors declare no competing interests.

Ethical approval and consent to participate

The study was conducted according to the principles of the Declaration of Helsinki. Written informed consent for this study was obtained from all study participants or their direct relatives, which was approved by the Ethics Committee of the First Hospital of Jilin University (2016-294).

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Sun, YY., Pang, SY., Qu, Y. et al. Prognostic value of beat-to-beat blood pressure variability parameters in patients after mechanical thrombectomy. Hypertens Res 48, 1155–1162 (2025). https://doi.org/10.1038/s41440-024-02060-4

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