Prognostic Value of Mild Asymptomatic Intracranial Atherosclerotic Stenosis in Patients With Hypertension.

IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Jin Zhang, Xiaofeng Tang, Yuesheng Qian, Jing Ma, Qin Wang, Huawei Ling, Kemin Chen, Yan Li, Pingjin Gao, Yan Wang, Dingliang Zhu
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Abstract

Background: Mild asymptomatic intracranial atherosclerotic stenosis (aICAS) is common in Chinese patients with hypertension. However, there are no data on its prognostic value in this population. The aim of the present study was to clarify the prevalence and associated cardiovascular risk factors of mild aICAS and determine its prognostic value for overall and cardiovascular mortality in patients with hypertension.

Methods: In total, 1,813 participants were evaluated for aICAS using computed tomographic angiography. The predictive effect of mild to severe aICAS on all-cause and cardiovascular mortality was evaluated using Kaplan-Meier survival curves and Cox regression analyses.

Results: The prevalence rate of mild aICAS was 35.7%. Poorly controlled hypertension, in combination with diabetes and dyslipidemia, was associated with aICAS. Patients with aICAS had an independently significant increase in the risk of all-cause and cardiovascular death, with adjusted hazard ratios (HRs) for mild to severe stenosis ranging from 1.56 to 3.30 for all-cause death and from 2.48 to 6.38 for cardiovascular death. Among the patients with mild aICAS, only those with more than two stenoses had increased mortality after adjustment, with an HR of 2.44 (95% CI: 1.42-4.18) for total death and 4.49 (95% CI: 1.82-11.05) for cardiovascular death.

Conclusions: A significant association between mild aICAS and mortality in stroke-free patients with hypertension was revealed. The results indicate that mild aICAS might be an imaging marker for cerebrovascular lesions in patients with hypertension and poor control of blood pressure and lipids in this population requires further research.

高血压患者轻度无症状颅内动脉粥样硬化狭窄的预后价值。
背景和目的:轻度无症状颅内动脉粥样硬化性狭窄(aICAS)在中国高血压患者中很常见。然而,目前尚无数据显示其在该人群中的预后价值。本研究旨在明确轻度 aICAS 的患病率和相关心血管风险因素,并确定其对高血压患者总体死亡率和心血管死亡率的预后价值:方法:共对1813名参与者进行了计算机断层扫描血管造影评估。采用卡普兰-梅耶生存曲线和 Cox 回归分析评估了轻度至重度 aICAS 对全因死亡率和心血管死亡率的预测作用:结果:轻度 aICAS 患病率为 35.7%。控制不佳的高血压、糖尿病和血脂异常与 aICAS 相关。轻度至重度血管狭窄的调整后危险比(HRs)从1.52到3.03不等,而心血管死亡的调整后危险比(HRs)从2.48到6.38不等。在轻度AICAS患者中,只有那些有两个以上狭窄的患者在调整后死亡率增加,全因死亡的HR为2.35(95% CI:1.36-4.04),心血管死亡的HR为4.41(95% CI:1.78-10.93):轻度 aICAS 与无脑卒中的高血压患者死亡率之间存在明显关联。结果表明,轻度 aICAS 可能是高血压患者脑血管病变的影像学标志物,该人群的血压和血脂控制不佳需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Hypertension
American Journal of Hypertension 医学-外周血管病
CiteScore
6.90
自引率
6.20%
发文量
144
审稿时长
3-8 weeks
期刊介绍: The American Journal of Hypertension is a monthly, peer-reviewed journal that provides a forum for scientific inquiry of the highest standards in the field of hypertension and related cardiovascular disease. The journal publishes high-quality original research and review articles on basic sciences, molecular biology, clinical and experimental hypertension, cardiology, epidemiology, pediatric hypertension, endocrinology, neurophysiology, and nephrology.
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