Objective To assess changes in indicators after stroke monitored by ambulatory blood pressure monitoring (ABPM) and their relationship with stroke prognosis.

Methods A total of 104 patients with acute ischemic stroke admitted within 24 hours after symptom onset were selected. On the first day of admission, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and heart rate (HR) were measured by ABPM for 24 hours. At 3 months after discharge, the modified Rankin scale was used to evaluate the patients' neurological function status, and the outcome of patients were classified into mild functional impairment, moderate functional impairment, and severe functional impairment based on the scores. Repeated measures ANOVA was used to compare the differences of time changes in 24-hour blood pressure or HR among patients with different outcomes. The relationship between blood pressure and HR changes and 3-month discharge outcomes was analyzed through ordinal logistic regression analysis.

Results At 3 months after discharge, 66 patients (63%) had mild functional impairment, 26 patients (26%) had moderate functional impairment, and 12 patients (11%) had severe functional impairment. Repeated measures ANOVA showed that there were statistically significant differences in SBP and HR at different time points on the first day of admission among the mild functional impairment group, moderate functional impairment group, and severe functional impairment group (P_time ＜ 0.01). After multivariable adjustment, the average 24-h SBP, minimum 24-h SBP, average 24-h DBP, average 24-h PP, minimum 24-h PP, coefficient of variation of 24-h PP, average 24-h HR, maximum 24-h HR, average levels of daytime SBP, DBP, PP, HR, and average levels of nighttime SBP, PP, HR on the first day of admission were all independent influencing factors of mild functional impairment (P ＜ 0.05); the average 24-h SBP, maximum 24-h SBP, minimum 24-h SBP, average 24-h DBP, maximum 24-h DBP, average 24-h HR, maximum 24-h HR, minimum 24-h HR, as well as the average levels of SBP, DBP, and HR during the daytime and nighttime were all independent influencing factors of severe functional impairment (P ＜ 0.05).

Conclusions The SBP, DBP, PP, HR on the first day of admission evaluated using ABPM are correlated with prognosis at 3 months after discharge in ischemic stroke patients.