Evaluation of The Effect of Ambulatory Blood Pressure and Heart Rate on in-Hospital Mortality and Long-Term Functional Outcomes in Ischemic Stroke

Background: This study investigates the effect of ambulatory blood pressure (ABP) and ambulatory heart rate (AHR) measurements on in-hospital mortality and long-term outcomes in patients with acute ischemic stroke (AIS).Methods: ABP and AHR were recorded by Holter monitoring at nighttime (21.00-07.00)and daytime (07.00-21.00).Patients were divided into survived and deceased groups, and into favourable and unfavourable outcome groups according to long-term functional outcomes.The 24-hour, daytime and nighttime ABP and AHR measurements were compared.Results: Nighttime, daytime and 24-hour mean heart rate (MHR) values were found to be higher in deceased group.In the discrimination according to the in-hospital mortality, the cut-off value of daytime MHR was 89.7 with 90.0% sensitivity and 82.4% specificity (P<.05).Similarly, the cut-off value of nocturnal MHR was 83.6 with 90.0% sensitivity and 76.5% specificity (P<.05).With a 1-unit increase in daytime MHR, the risk of developing mortality will increase 1.120 times [12% increase] (OR=1.120;95% CI=1.047-1.198). Conclusion:AHR measurements may be more helpful for clinicians to predict in-hospital mortality and long-term functional outcomes in patients with AIS than ABP measurements.