Dandan Wang1, Chunxue Wang, Yong Zhou, Anxin Wang, Xiang Gao, Shouling Wu, Xingquan Zhao. 1. aDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing bChina National Clinical Research Center for Neurological Diseases, Beijing cCenter of Stroke, Beijing Institute for Brain Disorders, Beijing dBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China eChanning Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School fDepartment of Nutrition, Harvard University School of Public Health, Boston, Massachusetts, USA gDepartment of Cardiology, Kailuan Hospital, Tangshan, China.
Abstract
BACKGROUND: The association between hypertension and cerebrovascular events is shown in some large-scale studies, but it remains unclear which blood pressure index is the most sensitive risk factor for cerebrovascular stenosis. METHODS: We investigated the potential associations between different blood pressure indexes and intracranial arterial stenosis (ICAS) in the study. The population-based Asymptomatic Polyvascular Abnormalities in Community study examined asymptomatic intracranial arterial abnormalities in a Chinese population and included participants aged more than 40 years without a history of stroke, transient ischemic attack, and coronary heart disease. ICAS was diagnosed by transcranial Doppler sonography. Blood pressure was measured with a mercury manometer three times; an average result of SBP and DBP was used, and mean arterial pressure (MAP) and pulse pressure (PP) were calculated for the statistical analysis. RESULTS: Out of the 4422 study participants, 711 (16.1%) showed an asymptomatic ICAS. After adjusting for age, waist circumference, drinking, diabetes, dyslipidemia, and blood concentration of uric acid, C-reactive protein, and homocysteine, ICAS was significantly associated with a higher SBP [from decile 6, odds ratio (OR) 3.093; 95% confidence interval (CI) 1.909, 5.012; P < 0.01), a higher MAP (from decile 7, OR 2.889; 95% CI 1.853, 4.504; P < 0.01), and a higher PP (from decile 5, OR 2.295;95% CI 1.463, 3.601; P < 0.01). Using a receiver-operating characteristic curve to estimate the predictive value of different blood pressure indexes for ICAS, SBP, MAP, and PP, were predictive indexes for ICAS and PP showed the largest predictive value (area under the curve = 0.737). CONCLUSIONS: The current study results suggest that SBP, MAP, and PP are all associated with asymptomatic ICAS. PP may be the most sensitive index to predict ICAS.
BACKGROUND: The association between hypertension and cerebrovascular events is shown in some large-scale studies, but it remains unclear which blood pressure index is the most sensitive risk factor for cerebrovascular stenosis. METHODS: We investigated the potential associations between different blood pressure indexes and intracranial arterial stenosis (ICAS) in the study. The population-based Asymptomatic Polyvascular Abnormalities in Community study examined asymptomatic intracranial arterial abnormalities in a Chinese population and included participants aged more than 40 years without a history of stroke, transient ischemic attack, and coronary heart disease. ICAS was diagnosed by transcranial Doppler sonography. Blood pressure was measured with a mercury manometer three times; an average result of SBP and DBP was used, and mean arterial pressure (MAP) and pulse pressure (PP) were calculated for the statistical analysis. RESULTS: Out of the 4422 study participants, 711 (16.1%) showed an asymptomatic ICAS. After adjusting for age, waist circumference, drinking, diabetes, dyslipidemia, and blood concentration of uric acid, C-reactive protein, and homocysteine, ICAS was significantly associated with a higher SBP [from decile 6, odds ratio (OR) 3.093; 95% confidence interval (CI) 1.909, 5.012; P < 0.01), a higher MAP (from decile 7, OR 2.889; 95% CI 1.853, 4.504; P < 0.01), and a higher PP (from decile 5, OR 2.295;95% CI 1.463, 3.601; P < 0.01). Using a receiver-operating characteristic curve to estimate the predictive value of different blood pressure indexes for ICAS, SBP, MAP, and PP, were predictive indexes for ICAS and PP showed the largest predictive value (area under the curve = 0.737). CONCLUSIONS: The current study results suggest that SBP, MAP, and PP are all associated with asymptomatic ICAS. PP may be the most sensitive index to predict ICAS.