Relationship Between Nocturnal Decline Rate of Systolic Blood Pressure,Serum 8-OHdG Levels and Post-Stroke Cognitive Im-pairment in Stoke Patients

YAN Jialan; ZHU Yanxia; JIAO Shusheng; FENG Lianyuan; MA Haoyuan

doi:10.13730/j.issn.2097-2148.2025.07.006

Abstract：Objective To investigate the relationship between nocturnal decline rate of systolic blood pressure,ser-um 8-hydroxydeoxyguanosine(8-OHdG)levels and post-stroke cognitive impairment(PSCI)in patients with stroke.Methods A total of 131 stroke patients treated in the author's hospital from October 2022 to October 2023 were selected as the study subjects,they were divided into cognitively normal group(n=78)and cognitive impairment group(n=53)based on the Montreal cognitive assessment(MoCA)scores.The general information,nocturnal decline rate of systolic blood pressure and serum 8-OHdG levels of patients with stroke were compared between the two groups.Spearman corre-lation analysis was applied to assess the correlation between the nocturnal decline rate of systolic blood pressure,serum 8-OHdG levels and MoCA scores in stroke patients,Logistic regression analysis was used to explore the factors affecting PSCI,receiver operating characteristic(ROC)curve analysis was performed to analyze the predictive efficacy of the noc-turnal decline rate of systolic blood pressure and serum 8-OHdG levels on PSCI.Results Compared with the cognitively normal group,the proportion of hypertension increased,the nocturnal decline rate of systolic blood pressure decreased and the nocturnal mean systolic blood pressure and serum 8-OHdG levels increased in stroke patients in the cognitive im-pairment group(all P＜0.05).Spearman correlation analysis showed that serum 8-OHdG levels of stroke patients were negatively correlated with MoCA score(r=-0.343,P=0.012),while the nocturnal decline rate of systolic blood pressure was positively correlated with Mo-CA score(r=0.413,P=0.002).Logistic regression analysis showed that the nocturnal decline rate of systolic blood pressure was a protective factor for PSCI(P＜0.05),and serum 8-OHdG level was a risk factor for PSCI(P＜0.05).ROC curve analysis revealed that the area under the curve(AUC)for diagnosing PSCI using the nocturnal decline rate of systolic blood pressure and serum 8-OHdG levels were 0.745(95％CI:0.662-0.828)and 0.891(95％CI:0.837-0.947),respectively,the AUC for diagnosing PSCI using the combined two detection were 0.923(95％CI:0.880-0.965).Conclusion The serum 8-OHdG level increases and the nocturnal decline rate of systolic blood pressure decreases in stroke patients with cognitive impairment.The combined detection of nocturnal decline rate of systolic blood pressure and serum 8-OHdG level has a good predictive effect on PSCI after stroke.