{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:44Z","timestamp":1787028644466,"version":"build-2736575974"},"reference-count":153,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T00:00:00Z","timestamp":1711670400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The management of blood pressure variability (BPV) in acute stroke presents a complex challenge with profound implications for patient outcomes. This narrative review examines the role of BPV across various stages of acute stroke care, highlighting its impact on treatment strategies and prognostic considerations. In the prehospital setting, while guidelines lack specific recommendations for BP management, emerging evidence suggests a potential link between BPV and outcomes. Among ischaemic stroke patients who are ineligible for reperfusion therapies, BPV independently influences functional outcomes, emphasising the need for individualised approaches to BP control. During intravenous thrombolysis and endovascular therapy, the intricate interplay between BP levels, recanalisation status, and BPV is evident. Striking a balance between aggressive BP lowering and avoiding hypoperfusion-related complications is essential. Intracerebral haemorrhage management is further complicated by BPV, which emerges as a predictor of mortality and disability, necessitating nuanced BP management strategies. Finally, among patients with acute subarachnoid haemorrhage, increased BPV may be correlated with a rebleeding risk and worse outcomes, emphasizing the need for BPV monitoring in this population. Integration of BPV assessment into clinical practice and research protocols is crucial for refining treatment strategies that are tailored to individual patient needs. Future studies should explore novel interventions targeting BPV modulation to optimise stroke care outcomes.<\/jats:p>","DOI":"10.3390\/jcm13071981","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T11:11:09Z","timestamp":1712229069000},"page":"1981","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Blood Pressure Variability in Acute Stroke: A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Christina","family":"Zompola","sequence":"first","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-609X","authenticated-orcid":false,"given":"Lina","family":"Palaiodimou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Voumvourakis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas","family":"Stefanis","sequence":"additional","affiliation":[{"name":"First Department of Neurology, \u201cAeginition\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6359-0023","authenticated-orcid":false,"given":"Aristeidis H.","family":"Katsanos","sequence":"additional","affiliation":[{"name":"Division of Neurology, McMaster University\/Population Health Research Institute, Hamilton, ON L8L2X2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Else C.","family":"Sandset","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Oslo University Hospital, N-0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8000-9739","authenticated-orcid":false,"given":"Estathios","family":"Boviatsis","sequence":"additional","affiliation":[{"name":"Second Department of Neurosurgery, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-3797","authenticated-orcid":false,"given":"Georgios","family":"Tsivgoulis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e17218","DOI":"10.1097\/MD.0000000000017218","article-title":"The risk of stroke and associated risk factors in a health examination population: A cross-sectional study","volume":"98","author":"Li","year":"2019","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1001\/jama.1981.03320190035023","article-title":"Blood pressure after stroke","volume":"246","author":"Wallace","year":"1981","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1161\/01.STR.22.4.527","article-title":"Factors influencing admission blood pressure levels in patients with acute stroke","volume":"22","author":"Carlberg","year":"1991","journal-title":"Stroke"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1161\/01.HYP.0000105052.65787.35","article-title":"High blood pressure in acute stroke and subsequent outcome: A systematic review","volume":"43","author":"Willmot","year":"2004","journal-title":"Hypertension"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1046\/j.1365-2796.2003.01291.x","article-title":"U-shaped relationship between mortality and admission blood pressure in patients with acute stroke","volume":"255","author":"Vemmos","year":"2004","journal-title":"J. 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