Focus on blood pressure levels and variability in the early phase of acute ischemic stroke with hypertension and carotid stenosis.
Focus on blood pressure levels and variability in the early phase of acute ischemic stroke with hypertension and carotid stenosis.
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DOI：
10.1111/jch.14385
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
He M;Cui B;Wang J;Xiao X;Wu T;Wang M;Yang R;Zhang B;Xu B;He X;Zhang G;Niu X;Li Z;Wang B;Xu B;Hui R;Wang Y
目的探讨高血压合并颈动脉狭窄(CAS)患者急性缺血性卒中(AIS)早期的最佳血压水平及BP和BP变异性的相对重要性。一项单中心队列研究包括750名患有高血压的AIS患者，并对CAS进行了测试。根据指南，参与者被分为三组：第一组(SBP：140和DBP：90)；第二组：(SBP：140-159和/或DBP：90-99)；第三组：(SBP≥160和/或DBP≥100)。用COX比例风险模型分析6个月时平均血压水平和变异性与预后(再发卒中、全因死亡和复合心血管事件)的关系。用线性回归和广义加性模型分析血压变异性与血压水平和脑血流量(CBF)的关系。在主要和次要结果方面，第1组比第2组发生更多事件，而第3组血压水平较高，但没有发现显著差异。收缩压变异性越低，预后越好，脑血流量越高。这些关联在CAS≥为50%的患者中更为显著。血压变异性与血压水平呈线性负相关。在AIS合并高血压和CAS的早期阶段，维持低血压变异性可能是改善预后的重要因素，而低血压水平(SBP/DBP)是有害的，特别是在CAS≥为50%的患者。
To investigate the optimal blood pressure (BP) levels and relative importance of BP and BP variability in the early phase of acute ischemic stroke (AIS) for hypertensive patients with carotid artery stenosis (CAS). A single‐center cohort study included 750 AIS patients with hypertension and tests were performed for CAS. Participants were categorized to Group 1 (SBP < 140 mm Hg and DBP < 90 mm Hg), Group 2: (SBP: 140–159 mm Hg and or DBP: 90–99 mm Hg), and Group 3: (SBP ≥160 mm Hg and/or DBP ≥100 mm Hg) according to the guidelines. The associations of mean BP levels and variability with outcomes (recurrent stroke, all‐cause death and the composite cardiovascular events) at 6 months were analyzed by Cox proportional hazard models. The associations of BP variability with BP levels and cerebral blood flow (CBF) were analyzed by linear regression and generalized additive models. Both for primary and secondary outcome, more events occurred in Group 1 compared with Group 2, while no significant difference was found in Group 3 with higher BP levels. Lower systolic BP variability showed better prognosis and higher CBF. The associations were more significant in patients with CAS ≥50%. BP variability exhibited a linear negative relationship with BP levels. In the early phase of AIS with hypertension and CAS, maintaining low blood pressure variability may be important to improve outcomes while low BP levels (SBP/DBP < 140/90 mm Hg) were harmful, especially in those patients with CAS ≥ 50%.
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影响因子：
3.7
作者：
Kang J;Hong JH;Jang MU;Choi NC;Lee JS;Kim BJ;Han MK;Bae HJ
通讯作者：
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作者：
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