ABSTRACT
BACKGROUND: The aim of this study was to assess the short and long-term effects of carotid artery stenting (CAS) procedure on blood pressure (BP) through ambulatory BP monitoring. METHODS: One hundred fifty three patients who underwent CAS for primary or secondary protection from December 2010 to September 2013 were enrolled to our study. The BP levels of total of 123 patients were monitored for 1 year. Thereafter, the pre-procedure levels of BP were compared with BP levels at the 24-hour and the first year intervals after the procedure. RESULTS: Systolic and diastolic BP levels at the 24-hour and the first year intervals after CAS were significantly lower than the pre-procedure BP levels. The mean 24-hour systolic BP was 113 ± 13 mmHg and diastolic BP was 63 ± 8 mmHg, both of which were significantly lower (p < 0.001 and p < 0.001 respectively), while the pre-procedure mean systolic BP was 133 ± 10 mmHg and the mean diastolic BP was 75 ± 9 mmHg. Moreover, the mean first-year systolic BP was 125 ± 10 mmHg with a decline of 8 ± 8 mmHg and mean diastolic BP was 71 ± 8 mmHg with a decline of 4 ± 7 mmHg, both of which were again significantly lower compared to the pre-procedure levels (p < 0.001 and p < 0.001 respectively). CONCLUSIONS: The results of our study suggested that systolic and diastolic BP levels diminished after CAS. Additionally, BP reduction continued even 1 year after the CAS.
ABSTRACT
BACKGROUND: It is well known that nondipper blood pressure (BP) pattern is associated with an increased cardiovascular risk in hypertensive patients. The aim of this study is to observe whether carotid artery stent (CAS) procedure returns nondipper BP pattern to dipper pattern in hypertensive patients. METHODS: Ambulatory BP monitorization (ABPM) was performed in 152 hypertensive patients who underwent CAS procedure 1 day before, and 1 day and 1 year after the procedure. BP monitorization of patients was classified as dipper and nondipper. BP parameters 1 year after CAS procedure were compared with preprocedure parameters. RESULTS: According to baseline ambulatory BP follow-ups, a total of 152 hypertensive patients with 122 (80%) nondippers and 30 (20%) dippers were enrolled in this study. According to ABPM results 1 year after CAS procedure, 78 patients (64%) who had nondipper pattern at first transformed into dipper pattern and 44 patients (36%) remained to be nondippers. Moreover, 1 year after CAS procedure, 18 patients (60%) who had dipper pattern at first transformed into nondipper pattern and 12 patients (40%) remained as dippers. When BP follow-up values at 1 year after CAS procedure were compared with BP readings before the procedure, 78 patients (51%) who were nondipper before the procedure transformed into dipper pattern (P ≤ .01), whereas 44 patients (29%) with nondipper pattern remained to be nondippers (P = .01). Twelve patients (7.9%) who had dipper pattern remained to have dipper pattern (P = .768). Eighteen patients who had dipper pattern (12%) transformed into nondipper pattern after the procedure (P < .01). The total number of nondipper pattern patients before CAS procedure was 80.3% (122 patients), whereas this percentage dropped to 40.8% (62 patients) after the CAS procedure (P < .01). CONCLUSIONS: During 1-year follow-up after CAS procedure, nondipper BP pattern transforms into dipper pattern. This result might be attributed to the contributory effect of CAS procedure to long-term cardiovascular protection.
