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Association of Systolic Blood Pressure with Progression of Symptomatic Intracranial Atherosclerotic Stenosis / 대한뇌졸중학회지
Journal of Stroke ; : 304-311, 2017.
Article in English | WPRIM | ID: wpr-51269
ABSTRACT
BACKGROUND AND

PURPOSE:

Elevated blood pressure (BP) is associated with greater severity of intracranial atherosclerotic stenosis (ICAS) and increased risk of ischemic stroke. Because little is known about the relationship of maintained BP level with progression of symptomatic ICAS (sICAS), we evaluated the independent association of maintained systolic BP (SBP) with risk of sICAS progression.

METHODS:

We analyzed the Trial of cilOstazol in Symptomatic intracranial Stenosis 2, which evaluated 402 stroke patients with sICAS (mean age, 64.5±11.3 years; male, 52.2%). Study participants were categorized into four groups according to mean SBP level low-normal ( < 120 mm Hg), normal to high-normal (120 to 139 mm Hg), high (140 to 159 mm Hg), and very-high (≥160 mm Hg). Progression of sICAS was defined as worsening in the degree of stenosis by ≥1 grade on the 7-month magnetic resonance angiography follow-up.

RESULTS:

sICAS progression was observed in 52 (12.9%) subjects. Percentages of sICAS progression by mean SBP category showed a J-shape pattern low-normal (21.4%), normal to high-normal (10.7%), high (11.4%), and very-high (38.9%). In multivariable analysis, compared to the normal to high-normal SBP group, odds ratios (95% confidence intervals) were low-normal, 1.88 (0.62–5.67); high, 1.06 (0.47–2.37); and very-high, 8.75 (2.57–29.86). Rate of sICAS progression by 10-mm Hg strata showed a similar pattern to findings from mean SBP category (9.47; 2.58–34.73 for SBP ≥160 mm Hg).

CONCLUSIONS:

Among individuals with a recent ICAS stroke, very-high SBP level during the short-term period after the index stroke was associated with significantly greater odds of sICAS progression.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Blood Pressure / Odds Ratio / Follow-Up Studies / Magnetic Resonance Angiography / Constriction, Pathologic / Stroke Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans / Male Language: English Journal: Journal of Stroke Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Blood Pressure / Odds Ratio / Follow-Up Studies / Magnetic Resonance Angiography / Constriction, Pathologic / Stroke Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans / Male Language: English Journal: Journal of Stroke Year: 2017 Type: Article