Systolic Blood Pressure Variability and Risk of Ischemic Stroke in Patients Receiving Hemodialysis

“Over a median follow-up of about four and a half years, 144 patients had an ischemic stroke, and each 10% increment in systolic variability was associated with roughly a 70% higher stroke risk after adjustment for mean blood pressure, comorbidities, medications, and dialysis factors. The association was most consistent for large artery atherosclerotic stroke, and diastolic variability showed no significant independent association. The practical message is that the pattern of your patient's pre-dialysis readings carries information that the average does not, and a highly erratic chart deserves attention rather than reassurance.”

“Erratic pre-dialysis systolic blood pressure independently predicts ischemic stroke, especially large artery stroke, beyond the mean. Look at the pattern, not just the average.”