Extreme dipping blood pressure pattern is associated with increased mortality in hemorrhagic stroke patients: a retrospective cohort study.

BACKGROUND

Blood pressure management strategies in patients with hemorrhagic stroke remain ineffective in reducing mortality. The circadian blood pressure pattern has been shown to be associated with mortality in patients with non-hemorrhagic stroke, but few studies have explored this association in patients with hemorrhagic stroke. We aimed to investigate the relationship between circadian blood pressure pattern and mortality in patients with hemorrhagic stroke.

METHODS AND RESULTS

Adult hemorrhagic stroke patients hospitalized in intensive care unit for more than 24 h in the Medical Information Mart for Intensive Care (MIMIC-IV) database were recruited for this retrospective cohort study. All patients were divided into the dipping group, the nondipping group, the reverse dipping group and the extreme dipping group. We used binary logistic regression analysis to explore the relationship between circadian blood pressure patterns and mortality of patients with hemorrhagic stroke. The overall cohort comprised 1040 patients. The patients in the extreme dipping group had higher mortality than other groups (57.1% versus 15.6%,17.0%, and 22.3%, respectively). After adjusting for covariates, the statistical analysis showed that the extreme dipping pattern was significantly associated with the mortality of hemorrhagic stroke patients in intensive care unit (odds ratio: 4.961[95%CI: 1.289-19.086]). Interaction analysis had no statistical significance in all results.

CONCLUSIONS

The extreme dipping pattern may be an important risk factor for increased mortality in patients with hemorrhagic stroke.