Relationship between blood pressure and stroke recurrence in patients with intracranial arterial stenosis
| Autor: | George A. Cotsonis, Michael J. Lynn, Seemant Chaturvedi, M.I. Chimowitz, Tanya N. Turan |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Time Factors Systole Hemodynamics Arterial Occlusive Diseases Blood Pressure Diastole Recurrence Physiology (medical) medicine Humans cardiovascular diseases Stroke Aged Univariate analysis Analysis of Variance Arterial stenosis Cerebral infarction business.industry Middle Aged medicine.disease Stenosis Blood pressure Anesthesia Practice Guidelines as Topic Female Cerebral Arterial Diseases Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 115(23) |
| ISSN: | 1524-4539 |
| Popis: | Background— Many clinicians allow blood pressure to run high in patients with intracranial stenosis to protect against hypoperfusion. We sought to determine whether higher blood pressure decreases the risk of stroke in these patients. Methods and Results— Data on 567 patients in the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial were analyzed. Time to ischemic stroke and stroke in the same territory of the stenotic vessel was compared in patients grouped by mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) during the study. Additional analyses were based on severity and location of stenosis. Ischemic stroke risk increased with increasing mean SBP and DBP on univariate analysis ( P P P =0.0008, P P =0.0065, P P =0.0002, P =0.0005) analyses. The increased risk of stroke with increasing SBP was driven largely by patients in the highest SBP group. Patients with moderate (P P =0.003) and stroke in the territory ( P =0.0002, P =0.010) with increased SBP and DBP. Patients with severe (≥70%) stenosis had increased risk of stroke and stroke in the territory with elevated DBP ( P =0.004, P =0.004). Conclusions— In patients with intracranial stenosis, higher blood pressure is associated with increased (not decreased) risk of ischemic stroke and stroke in the territory of the stenotic vessel. These findings argue strongly against the common clinical practice of maintaining high blood pressure in patients with intracranial stenosis. |
| Databáze: | OpenAIRE |
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