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EDITORIAL COMMENTARY
Year : 2020  |  Volume : 23  |  Issue : 1  |  Page : 9
 

Role of 24 hr blood pressure variability as a target therapeutic risk factor for poor functional outcome of acute ischemic stroke


1 Department of Biomedical Engineering, North Eastern Hill University, Shillong, Meghalaya, India
2 Department of Biomedical Engineering, SSN College of Engineering, Kalavakkam, Tamil Nadu, India

Date of Submission14-Oct-2019
Date of Acceptance14-Oct-2019
Date of Web Publication03-Jan-2020

Correspondence Address:
Dr. Dinesh Bhatia
Department of Biomedical Engineering, North Eastern Hill University, Shillong - 793 022, Meghalaya
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.AIAN_519_19

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How to cite this article:
Bhatia D, Bagyaraj S, Karthick S A. Role of 24 hr blood pressure variability as a target therapeutic risk factor for poor functional outcome of acute ischemic stroke. Ann Indian Acad Neurol 2020;23:9

How to cite this URL:
Bhatia D, Bagyaraj S, Karthick S A. Role of 24 hr blood pressure variability as a target therapeutic risk factor for poor functional outcome of acute ischemic stroke. Ann Indian Acad Neurol [serial online] 2020 [cited 2020 Feb 24];23:9. Available from: http://www.annalsofian.org/text.asp?2020/23/1/9/274802





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Knowledge about stroke-related risk factors and warning signs is crucial and important to prevent stroke morbidity and fatality. Now-a-days stoke is one of the major neurological disorder affecting a large patient population. Hence, there is an increasing need for tools and techniques to predict the outcome in post stroke conditions. In this juncture utilizing blood pressure variability (BVP) as effective parameter for analyzing and predicting stroke is a novel and good attempt by the authors. From the statistical analysis made by the author it is evident that the five parameters namely National institute of health stroke scale (NIHSS) score, 24 hr Average Real Variability-Systolic Blood Pressure (ARV-SBP), Age, on admission Random Blood Sugar (RBS), and on admission Systolic Blood Pressure (SBP) are enough to predict the patient post stroke outcome effectively. The manuscript is well organized and described with simple language so that both medical as well as engineering community researchers will understand the science behind the BPV and its relation to post stroke analysis. In the field of post-stroke analysis, the author reports that the Population Attributable Risk (PAR) value of the 24 hr BPV as novel and only few studies have used ARV index to measure BPV. ARV index to measure BPV is more reliable and gaining more attention in the field of stroke studies. In the outcome predictors section, the authors have given the relationship of certain parameter on poor outcome such as Systolic and diastolic BPV calculated by the index of ARV. Higher ARV values are proven to be associated with poor functional outcomes. Moreover, the authors consider in their paper the female sex as one of the parameters and the ratio of the males and females considered in the study are not equal which could affect the final study results and analysis. The authors also need to specify the tool employed for calculating the PAR. As it is stated that (PAR) software was employed to calculate the study finding or did they employ the R software used to calculate PAR values. Further the five parameters namely NIHSS score, 24 hr ARV-SBP, age, on admission RBS, and on admission SBP were ranked based on average PAR score, the authors must specify the basis of weightage allocation to these parameter while using Multiple Logistic Regression. In the results section, the (RBS) in not listed as independent parameter in the multiple regression analysis but it has been listed and ranked as independent parameter. As stated by the authors, in multiple regression analysis, the outcome predictors which were found to be independent (P = <0.05) were as follows: age, NIHSS score, on admission SBP and 24 hr ARV-SBP. The authors must provide conclusive evidence whether the medication given to the patient is biased, the effect of medicine on 24 hours BPV is not extensively discussed in this article. The conclusion has to be technically justified and correlated with the study results presented in the paper.






 

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