{"title":"颈动脉内膜中层厚度随基线血压水平的长期变化：J-STARS Echo 研究。","authors":"Shinichi Wada, Masatoshi Koga, Tatsuo Kagimura, Kazunori Toyoda, Yoji Nagai, Shiro Aoki, Tomohisa Nezu, Naohisa Hosomi, Hideki Origasa, Toshiho Ohtsuki, Hirofumi Maruyama, Masahiro Yasaka, Kazuo Kitagawa, Shinichiro Uchiyama, Kazuo Minematsu, Masayasu Matsumoto","doi":"10.1016/j.jns.2024.123342","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients.</p><p><strong>Methods: </strong>Patients aged 45-80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140 mmHg and diastolic BP [dBP] <90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients). Mixed effect models were used to examine differences in slope of mean carotid IMT increases annually over the 5-year observation period among three groups, and for two groups divided based on whether they were above or below certain BP cut-off levels set at every 1 mmHg, ranging between 139 and 161 mmHg for sBP, and 89-101 mmHg for dBP.</p><p><strong>Results: </strong>Of 792 patients, baseline mean carotid IMT in the G1-group (0.908 ± 0.152 mm) and G2-group (0.905 ± 0.145 mm) was significantly higher than the N-group (0.870 ± 0.153 mm) (P < 0.01, for both respectively). Although there was no significant difference in the increase among three groups (P = 0.091), the increase in patients above sBP 154, 159 and 160 mmHg or dBP 101 mmHg at baseline was higher than others (P < 0.05 for all).</p><p><strong>Conclusions: </strong>High baseline BP correlated with a high baseline carotid IMT and its subsequent 5-year increase in non-cardioembolic stroke patients.</p><p><strong>Clinical trial registration: </strong>http://www.</p><p><strong>Clinicaltrials: </strong>gov.</p><p><strong>Unique identifier: </strong>NCT00361530.</p>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"123342"},"PeriodicalIF":3.6000,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term changes in carotid intima-media thickness according to baseline blood pressure level: J-STARS Echo study.\",\"authors\":\"Shinichi Wada, Masatoshi Koga, Tatsuo Kagimura, Kazunori Toyoda, Yoji Nagai, Shiro Aoki, Tomohisa Nezu, Naohisa Hosomi, Hideki Origasa, Toshiho Ohtsuki, Hirofumi Maruyama, Masahiro Yasaka, Kazuo Kitagawa, Shinichiro Uchiyama, Kazuo Minematsu, Masayasu Matsumoto\",\"doi\":\"10.1016/j.jns.2024.123342\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients.</p><p><strong>Methods: </strong>Patients aged 45-80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140 mmHg and diastolic BP [dBP] <90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients). Mixed effect models were used to examine differences in slope of mean carotid IMT increases annually over the 5-year observation period among three groups, and for two groups divided based on whether they were above or below certain BP cut-off levels set at every 1 mmHg, ranging between 139 and 161 mmHg for sBP, and 89-101 mmHg for dBP.</p><p><strong>Results: </strong>Of 792 patients, baseline mean carotid IMT in the G1-group (0.908 ± 0.152 mm) and G2-group (0.905 ± 0.145 mm) was significantly higher than the N-group (0.870 ± 0.153 mm) (P < 0.01, for both respectively). Although there was no significant difference in the increase among three groups (P = 0.091), the increase in patients above sBP 154, 159 and 160 mmHg or dBP 101 mmHg at baseline was higher than others (P < 0.05 for all).</p><p><strong>Conclusions: </strong>High baseline BP correlated with a high baseline carotid IMT and its subsequent 5-year increase in non-cardioembolic stroke patients.</p><p><strong>Clinical trial registration: </strong>http://www.</p><p><strong>Clinicaltrials: </strong>gov.</p><p><strong>Unique identifier: </strong>NCT00361530.</p>\",\"PeriodicalId\":17417,\"journal\":{\"name\":\"Journal of the Neurological Sciences\",\"volume\":\"468 \",\"pages\":\"123342\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-01-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Neurological Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jns.2024.123342\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Neurological Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jns.2024.123342","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Long-term changes in carotid intima-media thickness according to baseline blood pressure level: J-STARS Echo study.
Background and aims: We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients.
Methods: Patients aged 45-80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140 mmHg and diastolic BP [dBP] <90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients). Mixed effect models were used to examine differences in slope of mean carotid IMT increases annually over the 5-year observation period among three groups, and for two groups divided based on whether they were above or below certain BP cut-off levels set at every 1 mmHg, ranging between 139 and 161 mmHg for sBP, and 89-101 mmHg for dBP.
Results: Of 792 patients, baseline mean carotid IMT in the G1-group (0.908 ± 0.152 mm) and G2-group (0.905 ± 0.145 mm) was significantly higher than the N-group (0.870 ± 0.153 mm) (P < 0.01, for both respectively). Although there was no significant difference in the increase among three groups (P = 0.091), the increase in patients above sBP 154, 159 and 160 mmHg or dBP 101 mmHg at baseline was higher than others (P < 0.05 for all).
Conclusions: High baseline BP correlated with a high baseline carotid IMT and its subsequent 5-year increase in non-cardioembolic stroke patients.
期刊介绍：
The Journal of the Neurological Sciences provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. JNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials).
JNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
