Photo Credit: Siarhei Khaletski

The following is a summary of “Association of blood pressure parameters on early neurological deterioration in patients with mild stroke and large vessel occlusion following medical management,” published in the February 2025 issue of BMC Neurology by Shi et al. 

Researchers conducted a retrospective study to assess the association between blood pressure (BP) metrics and early neurological deterioration of ischemic origin (END_i) in patients with mild stroke and large vessel occlusion (LVO) receiving the best medical management (BMM). 

They collected data from patients with mild stroke and LVO treated with BMM from January 2019 to December 2023. They recorded admission systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and 24-h SBP variability. They defined END_i as a National Institutes of Health Stroke Scale (NIHSS) score increase of ≥4 points within 24 h, excluding intracranial hemorrhage. 

The results showed that among 347 patients, END_i occurred in 42 (12.1%). The END_i group had higher admission SBP (158 vs. 131 mmHg, P < 0.001), SBP variability (32 vs. 14 mmHg, P < 0.001), and Tmax > 6 s volumes (63 vs. 40 ml, P < 0.001), with more vertebrobasilar occlusions (42.9% vs. 12.1%, P < 0.001). Multivariable analysis showed independent associations between END_i and the highest quartile of admission SBP (adjusted odds ratio [aOR] = 2.47, 95% CI = 1.47–4.29), SBP variability (aOR = 2.57, 95% CI = 1.34–5.18), Tmax > 6 s volumes (aOR = 2.09, 95% CI = 1.28–5.89), and vertebrobasilar occlusion (aOR = 3.19, 95% CI = 1.76–6.74). 

Investigators found that elevated admission SBP and large SBP variability were associated with END_i in patients with mild stroke and LVO receiving BMM. 

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04066-y