The Impact of Visitor Exposure on Patients’ Blood Pressure After Acute Ischemic Stroke: A Pilot Study

Abstract

Environmental stimulation on stroke units (SUs) may affect hemodynamic stability, but the impact of direct and indirect visiting exposure in shared rooms has not been well characterized. This study aimed to assess whether real-time exposure to visits directed to the study patient or to a roommate is associated with blood pressure (BP) variability. We performed a single-center retrospective cohort study. Automated blood pressure measurements were linked to nurse-recorded visitor status in consecutive acute ischemic stroke patients admitted to a university stroke unit over a 3-month period. Group comparisons were performed using the Kruskal–Wallis test followed by Dunn’s post hoc test. Additionally, Spearman’s rank correlation coefficients were calculated to assess the relationships between variables. A total of 8963 blood pressure readings from 87 patients were analyzed: no visitors accounted for 6607 (73.7%) readings, roommate visitors for 823 (9.2%), and own visitors for 1533 (17.1%). Visiting exposure showed time-dependent hemodynamic effects. Roommate visits were associated with higher pulse pressure (PP), systolic blood pressure (SBP), and mean blood pressure (MBP) at selected morning, early afternoon, and evening time points, whereas own visits were associated with lower PP at multiple time points. At 09:00, maximal differences in mean values between roommate visitors and own visitors reached 21 mmHg for PP and 27 mmHg for SBP. In conclusion, visits directed to the study patient were associated with lower pulse pressure at selected time points, whereas visits to roommates were associated with higher short-term BP values at selected times. In shared SU rooms, a roommate’s visitors may represent a modifiable environmental stressor. Ultimately, biobehaviorally informed visiting practices, strategic room allocation, and stimulus-reduction strategies may help optimize hemodynamic stability during acute stroke recovery.