Supine blood pressure normalised by daytime series values is independently associated with ischaemic wake-up stroke

Figures & data

Table 1. Baseline characteristics of the study participants.

Parameter	Overall	Wake-up stroke	Known-onset stroke	p
Age, years	63 (56–69)	63 (56–69)	62 (56–70)	0.879
Male sex, n (%)	88 (73%)	28 (77%)	60 (71%)	0.471
Admission National Institutes of Health Stroke Scale score	4 (3–8)	4 (3–7)	5 (3–9)	0.993
National Institutes of Health Stroke Scale score at day 7	2 (1–4)	2 (1–3)	2 (1–4)	0.231
Use of recombinant tissue plasminogen activator, n (%)	36 (30%)	2 (5%)	34 (41%)	<0.001
Previous stroke, n (%)	14 (12%)	5 (14%)	9 (11%)	0.906
Hypertension, n (%)	76 (63%)	25 (69%)	51 (61%)	0.649
Smoking status, n (%)	43 (36%)	12 (33%)	31 (37%)	0.436
Body mass index, kg/m^2	28 (24–30)	29 (24–30)	28 (24–30)	0.581
Prehospital antihypertensives, n (%)	60 (50%)	18 (50%)	42 (50%)	0.602
In-hospital antihypertensives, n (%)	79 (66%)	25 (69%)	54 (64%)	0.789
Admission glucose, mg/dL	116 (102–152)	108 (97–119)	121 (107–158)	0.001
Pulse wave velocity, m/s	9.6 (8.0–12.3)	9.3 (7.8–10.7)	9.9 (8.1–12.6)	0.105
Augmentation index normalised for heart rate of 75 bpm, %	26.2 ± 11.5	23.4 ± 10.9	27.3 ± 11.7	0.329
Total cholesterol, mg/dL	196.9 ± 45.1	196.9 ± 40.3	196.9 ± 47.3	0.996
Triglycerides, mg/dL	118.0 (83.0–176.0)	121.0 (83.0–161.0)	115.0 (82.5–184.5)	0.796
High-density lipoprotein, mg/dL	39.0 (34.0–47.0)	37.0 (33.0–44.0)	39.0 (34.0–48.0)	0.544
Low-density lipoprotein, mg/dL	130.0 ± 39.4	133.2 ± 36.5	128.5 ± 40.7	0.577
Brain natriuretic peptide, pg/mL	64.0 (32.0–122.0)	49.0 (43.0–104.0)	67.0 (28.0–128.5)	0.598
Modified Rankin scale score, points	2.0 (1.0–2.0)	2.0 (1.0–2.0)	2.0 (1.0–2.0)	0.344

Values are expressed as the mean ± standard deviation or median (interquartile range) unless otherwise indicated.

Table 2. BP parameters in ischaemic stroke patients.

Parameter	Overall	Known-onset stroke	Wake-up stroke	p
Supine office BP parameters
Systolic BP, mm Hg	134.0 (123.0–153.0)	136.5 (125.5–155.5)	129.0 (118.5–149.0)	0.077
Diastolic BP, mm Hg	79.8 ± 12.8	80.9 ± 13.3	76.9 ± 11.3	0.130
Mean BP, mm Hg	99.0 (89.0–109.0)	102.0 (93.0–110.0)	96.0 (85.5–106.0)	0.098
Pulse pressure, mm Hg	57.(47.0–70.0)	59.0 (48.0–70.0)	51.0 (47.0–67.0)	0.396
Heart rate, bpm	66.0 ± 11.5	67.0 ± 11.8	63.6 ± 10.4	0.152
ABPM parameters
Mean 24-h systolic BP, mm Hg	132.0 (122.0–143.0)	130.0 (121.0–143.0)	133.5 (125.0–144.5)	0.584
Mean 24-h diastolic BP, mm Hg	77.0 (71.0–84.0)	76.0 (71.0–84.0)	77.0 (70.5–84.5)	0.935
Mean daytime systolic BP, mm Hg	134.0 (125.0–145.5)	133.5 (125.0–145.5)	137.0 (125.0–145.0)	0.614
Mean daytime diastolic BP, mm Hg	79.0 (72.5–86.0)	79.0 (72.5–85.0)	78.5 (72.0–88.0)	0.879
Mean night-time systolic BP, mm Hg	128.0 (117.0–141.0)	126.0 (117.0–142.0)	128.0 (118.5–140.5)	0.538
Mean night-time diastolic BP, mm Hg	74.3 ± 11.1	74.0 ± 10.8	75.0 ± 11.8	0.657

ABPM: ambulatory blood pressure monitoring; BP: blood pressure.

Values are expressed as the mean ± standard deviation or median (interquartile range).

Table 3. Office-ambulatory BP differences among wake-up stroke versus non-wake-up stroke patients.

Parameter	Known-onset stroke	Wake-up stroke	p
Systolic daytime BP difference	4.12 (−2.48 to 11.31)	−1.92 (−11.55 to 3.95)	0.006
Diastolic daytime BP difference	1.27 (−7.46 to 10.67)	−6.33 (−15.63 to 8.70)	0.068
Mean daytime BP difference	2.00 (−6.86 to 11.65)	−6.20 (−12.32 to 7.42)	0.029
Systolic night-time BP difference	9.84 (0.00 to 18.25)	0.00 (−9.79 to 11.82)	0.003
Diastolic night-time BP difference	8.81 (−0.57 to 17.69)	0.00 (−9.21 to 12.05)	0.061
Mean night-time BP difference	7.82 (−2.47 to 20.39)	0.51 (−8.49 to 12.08)	0.026

Values are expressed as the median (interquartile range).

Table 4. Results of a multinominal logistic regression for distinguishing between wake-up stroke and known-onset stroke.

Parameter	Odds ratio	95% confidence interval	p
Sex	1.84	0.56–6.02	0.317
Age, years	1.02	0.98–1.06	0.440
Baseline National Institutes of Health Stroke Scale score	1.00	0.90–1.11	0.993
Admission glucose, mg/dL	0.99	0.98–1.01	0.308
Use of recombinant tissue plasminogen activator	0.10	0.02–0.46	0.003
Office-ambulatory systolic BP difference, %	0.96	0.92–1.00	0.039
Maximal daytime heart rate, bpm	0.97	0.94–1.00	0.085
Use of antihypertensives during hospitalisation	0.90	0.27–2.97	0.860