London, United Kingdom 2013 1 Stroke prevention A 10:30 - 10:40 Stroke risk markers of blood pressure variability: associations with Chronic Kidney Dis-ease (CKD) and identification in primary care D.S. Lasserson1, N. Scherpbier de haan2, J.F.M. Wetzels3, W.J.C. de Grauw4, V.A. van Gelder5, M.C.J. Biermans6, C. van Weel7, C.A. O’Callaghan8 Department of Primary Care Health Sciences, University of Oxford, Oxford, UNITED KINGDOM1,Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHER-LANDS2, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS3, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS4, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS5, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS6, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS7, Nuffield Department of Medicine, Uni-versity of Oxford, Oxford, UNITED KINGDOM8 Background High variability in visit-to-visit office BP measurements identifies patients at very high risk of stroke in cohorts of patients with TIA and in large hypertension treatment trials. CKD is strong-ly associated with greater cardiovascular risk, but known risk factors such as elevations in mean blood pressure do not fully account for the excess risk. We hypothesised that worsening CKD stage is associated with greater variability in visit-to-visit blood pressure and so can be used to identify patients with accelerated stroke risk in primary care. Methods Data were analysed from a population of 207,468 patients registered at 47 primary care prac-tices in the CONTACT study in Nijmegen, Netherlands. Measures of BP variability that are associated with stroke risk were analysed: successive residual variability independent of mean (SRVIM), absolute residual variability independent of mean (ARVIM) and standard deviation independent of mean (SDIM). Two way analyses of variance (ANOVA) tested the interaction between BP variability, age and CKD stage. Results 63,073 patients (CKD stage 3-5 prevalence 11.3%) aged >18 had at least one measure of renal function. Of these 19,175 (30%) had at least 7 blood pressure measurements for variability as-sessment. Associations were seen with increased variability and age as ARVIM, SRVIM and SDIM all increased with each age decile (ANOVA, p<0.001 for all three measures). How-ever, variability increased with both age and CKD as a significant relationship was observed between worsening CKD stage and increased BP variability within all age deciles (Two way ANOVA, ARVIM F = 1.6, p = 0.020, SRVIM F = 1.7 p = 0.020, SDIM F = 1.6, p = 0.035). Conclusion Reduced renal function is associated with increased BP variability at all ages. Patients with high stroke risk BP patterns are easily identifiable in primary care from routine clinical data and should be targeted for further prognostic and intervention studies to reduce stroke. Cerebrovasc Dis 2013; 35 (suppl 3)1-854 119 Percentage of penumbral tissue loss in dependence of time (n=51). Percentage of penumbral tissue loss in dependence of time in patients with good collaterals and TICI 2b/3 reperfusion but without asymptomatic ICH (n=15) 10:30-12:30 Oral Session Room 9,10 Stroke prevention A Chairs: A. Algra, The Netherlands and K.S. Wong, Hong-Kong
Karger_ESC London_2013
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