Unveiling the predictive synergy of red cell distribution width and peak morning home systolic blood pressure: a dual biomarker approach for cognitive risk stratification in hypertensive minor stroke

Unveiling the predictive synergy of red cell distribution width and peak morning home systolic blood pressure: a dual biomarker approach for cognitive risk stratification in hypertensive minor stroke

AimThis study aims to evaluate the predictive value of combining red cell distribution width (RDW) and peak morning home systolic blood pressure (SBP) for post-stroke cognitive impairment (PSCI) in hypertensive patients with minor stroke.MethodsA prospective cohort study enrolled 430 patients, rando...

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Bibliographic Details
Main Authors: Yimin Shu, Jie Chen, Yanjin Song, Wuhong Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Neurology
Subjects:
red cell distribution width
peak morning home systolic blood pressure
hypertension
cognitive impairment
minor stroke
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1637561/full
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Summary:AimThis study aims to evaluate the predictive value of combining red cell distribution width (RDW) and peak morning home systolic blood pressure (SBP) for post-stroke cognitive impairment (PSCI) in hypertensive patients with minor stroke.MethodsA prospective cohort study enrolled 430 patients, randomly stratified into training (n = 301) and validation (n = 129) cohorts. Multivariable logistic regression and random forest model were employed for analysis.ResultsBoth RDW and peak morning home SBP emerged as independent risk factors for PSCI (OR = 70.95 and 1.104, respectively; p < 0.001 for both). The combined model significantly improved predictive performance, achieving an area under the curve (AUC) of 0.925 (95% CI: 0.901–0.948), surpassing individual biomarkers (RDW: AUC = 0.883; peak morning home SBP: AUC = 0.765). Subgroup analyses demonstrated superior discriminative capacity in coronary heart disease (AUC = 0.956) and female patients (AUC = 0.925).ConclusionThe integration of RDW and peak morning home SBP provides an efficient, cost-effective, and clinically translatable tool for cognitive risk stratification in hypertensive patients with minor stroke, offering enhanced precision over conventional single-biomarker approaches.
ISSN:1664-2295

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