In a secondary analysis of ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage II) trial, researchers demonstrate that increased systolic blood pressure variability (BPV) is associated with worse long-term neurological outcome following acute ischemic stroke. The primary outcome of this study was a 3-month follow-up modified Rankin Scale of 3 to 6, and the secondary outcome was a utility-weighted modified Rankin Scale. Researchers calculated blood pressure mean and variability using systolic blood pressure from the acute period (2-24 hours post-randomization) and subacute period (days 2, 3, and 7). The acute period included 913 patients and the subacute included 877. They found:

• For 5 different statistical measures of systolic BPV, there was a consistent association between increased BPV and worse neurological outcome in both the acute and subacute periods.
• This association was not found for systolic blood pressure mean.