Clinical Interventions in Aging最新文献

{"title":"Preoperative Nutritional Status Screened by MNA-SF Predicts Major Complications in Elderly Patients Undergoing Lumbar Fusion Surgery.","authors":"Di Han, Shuai-Kang Wang, Peng Cui, Chao Kong, Peng Wang, Shi-Bao Lu","doi":"10.2147/CIA.S481610","DOIUrl":"10.2147/CIA.S481610","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the role of Mini Nutritional Assessment-Short Form (MNA-SF) in predicting postoperative complications in older patients (≥75 years) undergoing lumbar fusion surgery.</p><p><strong>Patients and methods: </strong>Patients who had undergone posterior lumbar fusion surgery between June 2019 and September 2021 were enrolled. Those with an MNA-SF score of 12 or higher were categorized as the Nourished group, while those with a score less than 12 were placed in the Malnutrition-Risk group. Preoperative, intraoperative, and postoperative variables between groups were compared. Patients were then re-classified based on the presence of major complications, univariate analysis and multivariate logistic regression was used to identify risk factors for major complications.</p><p><strong>Results: </strong>A total of 240 patients were enrolled, with 182 in the Nourished group and 58 in the Malnutrition-Risk group. The Malnutrition-Risk group exhibited a higher incidence of major complications (46.6% vs 23.1%, p = 0.001) and comprehensive complications index (18.42 ± 18.00 vs 12.65 ± 15.87, p = 0.021), Oswestry Disability Index (27.52 ± 23.44 vs 20.45 ± 20.42, p = 0.029) and longer recovery times (12.53 days vs 10.15 days, p =0.033). Length of stay (LOS) were also increased in the Malnutrition-Risk group (19.22 ± 10.67 vs 16.04 ± 7.69, p = 0.014). Multiple regression analysis identified nutritional risk and malnutrition, as assessed by MNA-SF, as independent factors associated with postoperative major complications (OR 2.81, 95% CI 1.42-5.53, p = 0.003).</p><p><strong>Conclusion: </strong>Preoperative nutritional risk or malnutrition is an independent risk factor for major complications among older patients undergoing posterior lumbar fusion surgery. The MNS-SF emerges as a convenient and effective tool for promptly screening the nutritional status of older patients, prompting subsequent nutritional evaluation or intervention before surgery.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2031-2042"},"PeriodicalIF":3.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Number of Retrieval Attempts and the Association of Intravenous Tirofiban with Symptomatic Intracranial Hemorrhage in Patients with Successful Endovascular Therapy: Results of the RESCUE BT Trial.","authors":"Xiangxiang Peng, Changwei Guo, Jie Yang, Shitao Fan, Xu Xu, Jinfu Ma, Zhixi Wang, Shihai Yang, Wenjie Zi, Xianjun Huang, Hongjun Wang","doi":"10.2147/CIA.S481084","DOIUrl":"10.2147/CIA.S481084","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between intravenous tirofiban, the number of retrieval attempts and symptomatic intracranial hemorrhage (sICH) in patients with successful EVT.</p><p><strong>Patients and methods: </strong>We used the data from the Endovascular Treatment With versus Without Tirofiban for Patients with Large Vessel Occlusion Stroke (RESCUE BT) Trial. The primary outcome was sICH, which was defined according to the Heidelberg Bleeding Classification. The association between the number of retrieval attempts and the rate of sICH was investigated using multivariable logistic regression.</p><p><strong>Results: </strong>A total of 866 patients were included in our analysis. In overall cohort, tirofiban (OR: 1.853, 95% CI: 1.039-3.307) and more than 2 passes (3 versus 0-1: OR: 2.482, 95% CI: 1.124-5.481; 2 versus 0-1: OR: 0.813, 95% CI: 0.389-1.696) were significantly associated with the occurrence of sICH. A significant interaction between the use of tirofiban and the increasing number of attempts was found (p for interaction = 0.02), whereby the presence of sICH was significantly associated with tirofiban (OR: 5.534, 95% CI: 1.586-19.315) in the subgroup of multiple passes (>2 passes group), while none was seen in the subgroup of 0-2 passes. The results of the sensitivity analysis also showed that more than 2 passes (3 versus 1: OR: 2.841, 95% CI: 1.102-7.323; 2 versus 1: OR: 0.852, 95% CI: 0.346-2.097) were significantly associated with the occurrence of sICH in the tirofiban group but not in the placebo group.</p><p><strong>Conclusion: </strong>In patients with multiple attempts, intravenous tirofiban may increase the risk of sICH. Further research and individualized risk assessment are necessary to determine the most appropriate strategy of intravenous tirofiban for EVT patients, especially considering details of thrombectomy procedures.</p><p><strong>Registration: </strong>: URL: http:// www.chictr.org.cn; Unique identifier: ChiCTR-INR-17014167.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"2001-2012"},"PeriodicalIF":3.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unfavourable Outcomes in Older Adults with Oral Frailty: A Scoping Review.","authors":"Sheng-Rui Zhu, Xiu-Juan Feng, Wen-Kai Zheng, Xing-Rui Niu, Shu-Tian Mo, Wen-Zhen Tang","doi":"10.2147/CIA.S487329","DOIUrl":"10.2147/CIA.S487329","url":null,"abstract":"<p><strong>Background: </strong>The significant occurrence of oral frailty (OF) in older patients highlights the necessity of addressing this concern. OF is associated with complications and mortality in elderly patients. The objective of this study is to identify unfavorable outcomes in older patients with OF to increase awareness and mitigate risks.</p><p><strong>Methods: </strong>This review employed specific MeSH terms to perform an extensive literature search on OF and its unfavorable outcomes across PubMed, Web of Science, Embase, Cochrane Library, Scopus, and CINAHL databases. The review included English-language papers published from inception to March 31, 2024, focusing on individuals aged 60 and above, adverse outcomes related to OF, and studies employing cross-sectional or cohort designs.</p><p><strong>Results: </strong>The review comprised 28 articles: 20 cross-sectional and 8 prospective cohort studies. Among these articles, 10 were rated as \"Good\" and 18 as \"Fair\", reflecting the high quality of the literature. Next, 20 OF assessment tools were summarized, and the most frequently used methods for assessing OF were the methods of Tanaka et al and Oral Frailty Index-8 (OF-8). The most frequently unfavorable outcomes related to OF in the elderly were physical frailty, malnutrition, low dietary variety, social withdrawal, disability, and low gait speed.</p><p><strong>Conclusion: </strong>High levels of OF significantly increase the risk of adverse outcomes in older adults, including physical frailty, malnutrition, low dietary variety, social withdrawal, disability, and low gait speed. Effective risk stratification and management are essential to reduce these outcomes.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1979-1995"},"PeriodicalIF":3.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an Emergency-Based FASE Strategy on Treating Geriatric Patients with Femoral Neck Fracture: A Retrospective Propensity Score-Matched Study [Letter].","authors":"Hejia Wan, Shuning Wang, Lanxia Pan","doi":"10.2147/CIA.S507331","DOIUrl":"10.2147/CIA.S507331","url":null,"abstract":"","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1997-1999"},"PeriodicalIF":3.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Validation of a Predictive Model for Long-Term Major Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction.","authors":"Peng Yang, Jieying Duan, Mingxuan Li, Rui Tan, Yuan Li, Zeqing Zhang, Ying Wang","doi":"10.2147/CIA.S486839","DOIUrl":"https://doi.org/10.2147/CIA.S486839","url":null,"abstract":"<p><strong>Purpose: </strong>Current scoring systems used to predict major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) lack some key components and their predictive ability needs improvement. This study aimed to develop a more effective scoring system for predicting 3-year MACE in patients with AMI.</p><p><strong>Patients and methods: </strong>Our statistical analyses included data for 461 patients with AMI. Eighty percent of patients (n=369) were randomly assigned to the training set and the remaining patients (n=92) to the validation set. Independent risk factors for MACE were identified in univariate and multifactorial logistic regression analyses. A nomogram was used to create the scoring system, the predictive ability of which was assessed using calibration curve, decision curve analysis, receiver-operating characteristic curve, and survival analysis.</p><p><strong>Results: </strong>The nomogram model included the following seven variables: age, diabetes, prior myocardial infarction, Killip class, chronic kidney disease, lipoprotein(a), and percutaneous coronary intervention during hospitalization. The predicted and observed values for the nomogram model were in good agreement based on the calibration curves. Decision curve analysis showed that the clinical nomogram model had good predictive ability. The area under the curve (AUC) for the scoring system was 0.775 (95% confidence interval [CI] 0.728-0.823) in the training set and 0.789 (95% CI 0.693-0.886) in the validation set. Risk stratification based on the scoring system found that the risk of MACE was 4.51-fold higher (95% CI 3.24-6.28) in the high-risk group than in the low-risk group. Notably, this scoring system demonstrated better predictive ability than the GRACE risk score (AUC 0.776 vs 0.731; <i>P</i>=0.007).</p><p><strong>Conclusion: </strong>The scoring system developed from the nomogram in this study showed favorable performance in prediction of MACE and risk stratification of patients with AMI.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1965-1977"},"PeriodicalIF":3.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Risk Prediction of Elevated Serum Uric Acid Levels in Older Adults: A Longitudinal Cohort Study.","authors":"Dexian Zhang, Xinxin Xu, Zhibin Ye, Zhenxing Zhang, Jing Xiao","doi":"10.2147/CIA.S476806","DOIUrl":"10.2147/CIA.S476806","url":null,"abstract":"<p><strong>Objective: </strong>To develop and externally validate a nomogram to predict elevated serum uric acid (SUA) levels in older adults.</p><p><strong>Study design: </strong>This is a longitudinal Chinese cohort study.</p><p><strong>Methods: </strong>A cohort of 2788 older adults was established at Huadong Hospital, followed-up for at least one year, and screened for risk factors for elevated SUA levels. A logistic regression model was built to predict elevated SUA, and its performance was validated.</p><p><strong>Results: </strong>The risk prediction model showed good discrimination ability in both the development cohort (area under the curve (AUC) = 0.82; 95% confidence interval (CI) =0.79~0.86) and the external validation cohort (AUC=0.76; 95% CI=0.70~0.82). The model was adequately calibrated, and the predictions correlated with the observed outcome (<i>χ</i> ² = 6.36, <i>P</i> = 0.607). Men were more prone to elevated SUA levels than women were, and a baseline SUA level ≥360 μmol/L was a common risk factor for both males and females. Proteinuria status was an additional risk factor for males, whereas a baseline estimated glomerular filtration rate (eGFR)<60 mL/min·1.73 m² and diabetes status were additional risk factors for females.</p><p><strong>Conclusion: </strong>The externally validated nomogram, which is predictive of elevated SUA in older adults, might aid in the detection of individual diseases, the development of preventive interventions and clinical decision-making.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1951-1964"},"PeriodicalIF":3.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between VISTA and Vascular Cognitive Impairment in Older Chinese Adults: A Cross-Sectional Study.","authors":"Dan Liu, Li-Jun Chi","doi":"10.2147/CIA.S474209","DOIUrl":"10.2147/CIA.S474209","url":null,"abstract":"<p><strong>Purpose: </strong>Vascular cognitive impairment(VCI) ranks as the second most prevalent type of dementia.Increasing evidence has shown that inflammation and multi-faceted neuro-immune interactions integrate systemic and central inflammatory pathways, thereby inducing vascular tissue injury and contributing to the development of vascular cognitive impairment (VCI).V-type immunoglobulin-like suppressor of T cell activation (VISTA) is an Negative checkpoint regulators(NCR) that is associated with CNS homeostasis, interactions with peripheral immunity and CNS inflammation.The primary objective of this study was to seek the correlation between VISTA and VCI in patients with cardiovascular risk factors.Our secondary objective was to explore the potential of VISTA as a biomarker for VCI.</p><p><strong>Patients and methods: </strong>We enrolled individuals with cardiovascular risk factors in this cross-sectional study research and categorized them into two groups: without cognitive impairment (control) and with cognitive impairment (VCI). VISTA expression in peripheral blood mononuclear cells (PBMCs) was analyzed using relative quantitative polymerase chain reaction. VISTA expression was identified in monocyte subsets using flow cytometry. We use Enzyme linked immunosorbent assay to detect inflammatory factors in serum.</p><p><strong>Results: </strong>In PBMC in patients with VCI, the expression of VSIR was significantly reduced. In contrast to controls, fasting glucose, fibrosis, and the levels of interleukin 6 (IL-6) in VCI patients were noticeably higher, and uric acid levels were significantly lower. Vsir mRNA expression in PBMCs correlated negatively with IL-6 levels, Trail Making Test B scores, and Hachinski scores and positively with Boston Naming Test scores. In intermediate monocytes, flow cytometry showed reduced Vsir expression, which was connected with VCI. The percentage of intermediate monocytes, uric acid, and the VISTA mean fluorescence intensity on intermediate monocytes were shown to be independent factors to VCI by multivariate logistic regression analysis.</p><p><strong>Conclusion: </strong>Decreased VISTA promotes the occurrence of VCI in patients with cardiovascular risk factors by promoting monocytes toward the proinflammatory intermediate monocyte subset. VISTA may serve as a potential biomarker for distinguishing VCI in individuals with cardiovascular risk factors.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1939-1949"},"PeriodicalIF":3.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Values of H-Type Hypertension in Patients with Large Vessel Occlusion.","authors":"Dongjing Xie, Junfang Wan, Changwei Guo, Jie Yang, Jiacheng Huang, Zhouzhou Peng, Jiandi Huang, Linyu Li, Shitao Fan, Dahong Yang, Wenzhe Sun, Wenjie Zi, Fengli Li, Feng Peng, Jinrong Hu, Qingwu Yang","doi":"10.2147/CIA.S488000","DOIUrl":"10.2147/CIA.S488000","url":null,"abstract":"<p><strong>Background and purpose: </strong>Many patients who gained successful recanalization by endovascular treatment (EVT) with acute large vessel occlusion (LVO) did not have the favorable outcome. The study aimed to assess the association between H-type hypertension and clinical prognosis in patients with LVO after receiving EVT.</p><p><strong>Methods: </strong>Our study enrolled patients from the Endovascular Treatment With versus Without Tirofiban for Stroke Patients with Large Vessel Occlusion (RESCUE BT) Trial. H-type hypertension is defined as patients with hypertension and homocysteine (Hcy) ≥10µmol/L. The primary outcome was a favorable functional outcome, defined as a score of 0-2 on the modified Rankin Scale (mRS) at 90 days. The secondary outcomes were mortality, successful recanalization, futile recanalization, and symptomatic intracerebral hemorrhage (sICH).</p><p><strong>Results: </strong>The plasma homocysteine level was recorded for 215 patients with hypertension in our study. Among those patients, 172 patients (80%) were founded with Hcy ≥10µmol/L (H-type hypertension), and 43 patients (20%) with Hcy <10µmol/L (non-H-type hypertension). The probability of favorable outcome decreased with homocysteine increasing in patients with hypertension. H-type hypertension was associated with a low probability of favorable outcome (adjusted odds ratio (aOR), 0.38 [95% confidence interval (CI), 0.18-0.80]; <i>p</i> = 0.01) at 90 days. The effects of H-type hypertension on mortality (aOR, 1.90 [95% CI, 0.67-5.39]; <i>p</i> = 0.23) and sICH (aOR, 0.55 [95% CI, 0.13-2.29]; <i>p</i> = 0.41) were not significant.</p><p><strong>Conclusion: </strong>Our findings suggest that patients with H-type hypertension have a lower likelihood of achieving favorable outcomes but do not have an increased mortality rate within 90 days.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1907-1917"},"PeriodicalIF":3.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postinduction Hypotension and Adverse Outcomes in Older Adults Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Cohort Study.","authors":"Ting-Ting Ni, Yuan-Yuan Yao, Xiao-Xia Zhou, Tao Lv, Jing-Cheng Zou, Ge Luo, Jin-Ting Yang, Da-Wei Sun, Qi Gao, Ting-Ting Wang, Rui-Yu Wang, Xin-Chen Tao, Min Yan","doi":"10.2147/CIA.S487629","DOIUrl":"10.2147/CIA.S487629","url":null,"abstract":"<p><strong>Purpose: </strong>Postinduction hypotension (PIH), occurring between anaesthesia induction and surgical incision, is particularly concerning in older adults undergoing transcatheter aortic valve replacement (TAVR) due to their multiple comorbidities and age-related cardiovascular changes. This study aimed to assess the relationship between PIH and postoperative adverse events in TAVR patients.</p><p><strong>Patients and methods: </strong>A total of 777 patients underwent TAVR at The Second Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2020 to February 28, 2023. Four thresholds of MAP were defined, including two absolute thresholds (<65, <60 mmHg) and two relative thresholds (20% and 30% lower than baseline). The relationships between PIH and the composite outcome, which included all-cause in-hospital mortality, stroke, acute kidney injury (AKI), and myocardial infarction (MI), were examined using unadjusted analysis, 1:1 propensity score matching(PSM), and inverse probability of treatment weighting (IPTW).</p><p><strong>Results: </strong>A total of 643 older adults were included in the study ultimately. The composite outcome incidence was significantly greater in patients with PIH than in those without PIH (relative risk [RR]: 2.47, 95% CI: 1.66-3.73 for MAP <60 mmHg; RR: 1.66, 95% CI: 1.14-2.46 for a >30% decrease from baseline). PIH was significantly associated with stroke (RR: 5.22, 95% CI: 1.98-17.75) and AKI (RR: 2.82, 95% CI: 1.73-4.79) with a MAP <60 mmHg.</p><p><strong>Conclusion: </strong>PIH significantly increases the risk of composite outcomes, especially stroke and AKI, in TAVR patients.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1919-1938"},"PeriodicalIF":3.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Control for Patients with Middle Cerebral Artery Severe Stenosis or Occlusion.","authors":"Zheng Li, Guang-Xin Duan, Jia-Hui Zhang, Yun Xu, Yun Luo","doi":"10.2147/CIA.S477281","DOIUrl":"10.2147/CIA.S477281","url":null,"abstract":"<p><strong>Background: </strong>Chronic hypertension is an independent risk factor for ischemic stroke and worsens prognosis. However, the level of blood pressure control in hypertensive patients with severe intracranial stenosis is controversial.</p><p><strong>Purpose: </strong>To investigate the effect of different levels of blood pressure on cerebral perfusion in patients with middle cerebral artery severe stenosis or occlusion.</p><p><strong>Materials and methods: </strong>A total of 105 patients with isolated steno-occlusive middle cerebral artery (MCA) diagnosed by digital subtraction angiography (DSA) were enrolled, and PWI was compulsory. Relative risk factors were obtained by intergroup analysis in both hypertensive and non-hypertensive groups, and multivariable logistic regression was performed to determine whether hypertension was independently associated with PWI values. Next, the effects of different levels of blood pressure levels on cerebral perfusion as a whole and subgroup were further compared.</p><p><strong>Results: </strong>The hypertension (HT) group (Am 1.04±0.05, Lm 1.07±0.06, Pm 1.07±0.05) demonstrated lower cerebral perfusion pressure at a larger rMTT (p=0.0001, 0.004, 0.006) than the nonhypertension (NHT) group (Am 1.01±0.21, Lm 1.04±0.04, Pm 1.04±0.04). After adjustment for age, diabetes, and fibrinogen (FIB), HT was independently associated with the rMTT of Am, Lm, and Pm (P=0.015, 0.001, 0.022). Significant differences were observed with HT+SBP<140 (p=0.035, 0.048, 0.049) and HT+DBP<80 (p=0.034, 0.045, 0.055) in rMTT compared with NHT.</p><p><strong>Conclusion: </strong>Chronic hypertension might damage cerebral perfusion. Strictly control of blood pressure (<140/80mmHg) in hypertensive patients with intracranial artery stenosis will further reduce ipsilateral cerebral perfusion.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1897-1905"},"PeriodicalIF":3.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}