ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Correlation between blood pressure variability and prognosis of endovascular therapy in ischemic stroke due to middle cerebral artery occlusion
Hao Tao 1,2
Yi Li 1,2
Huan Liu 3,2
Xiang Fan 1,2
Meng-Yu Zhong 3,2
Jian-Hong Wang 2
Shu Yang 2
Neng-Wei Yu 2
Bing-Hu Li 2
1. University of Electronic Science and Technology of China, Chengdu, China
2. Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
3. Southwest Medical University, Luzhou, China
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Abstract
Purpose: To evaluate the impact of post-endovascular therapy (EVT) systolic, diastolic, and pulse pressure variability on 3-month functional outcomes in patients with middle cerebral artery occlusion. Methods: Patients were classified as having good (mRS 0–2) or poor (mRS 3–6) 90-day outcomes. We compared 48-hour postoperative BP parameters and BPV indices (SD, CV, and ARV). Multivariable logistic regression adjusted for age, baseline NIHSS, hypertension, atrial fibrillation, and pre-stroke mRS was used to examine associations between BPV and outcome. Results: The average real variability of systolic blood pressure (SBPARV: 10.08 vs. 7.89, P<0.001), diastolic blood pressure (DBPARV: 8.42 vs. 7.87, P=0.006), and pulse pressure (PPARV: 11.00 vs. 8.26, P<0.001) were significantly higher in the poor prognosis group than in the good prognosis group. Multivariable logistic regression showed that SBPARV (OR = 2.619, 95% CI 1.606–4.271; P < 0.001) and PPARV (PPARV: 11.00 vs. 8.26, P<0.001) were independently associated with poor prognosis at 3 months. Conclusion: In this retrospective cohort, higher postoperative SBP ARV and PP ARV were independently associated with poor 90-day functional outcome after EVT; however, given the small sample size and observational design, the predictive value of BPV parameters is likely limited. BPV may be an epiphenomenon of more severe stroke rather than a causal determinant or clinically actionable target.
Summary
Keywords
blood pressure variability, endovascular treatment, Mechanical thrombectomy, Outcome, Stroke
Received
18 October 2025
Accepted
09 February 2026
Copyright
© 2026 Tao, Li, Liu, Fan, Zhong, Wang, Yang, Yu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Neng-Wei Yu; Bing-Hu Li
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