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Association between H-type Hypertension and Asymptomatic Extracranial Artery Stenosis
Jia Zhang1,2,3,4, Yanfang Liu1,2,3,4, Anxin Wang1,2,3,4,5
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
Insights
H-type hypertension, a condition combining high blood pressure and high homocysteine, significantly increases the risk of developing asymptomatic extracranial artery stenosis (ECAS). This finding highlights H-type hypertension as a key factor in carotid atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Vascular Biology
Background:
- Asymptomatic extracranial artery stenosis (ECAS) is a known stroke risk factor.
- H-type hypertension (hypertension with hyperhomocysteinemia) is linked to cardio-cerebrovascular diseases.
- The specific impact of H-type hypertension on ECAS remains largely uncharacterized.
Purpose of the Study:
- To investigate the association between H-type hypertension and the prevalence of asymptomatic ECAS.
- To determine if H-type hypertension is an independent risk factor for ECAS.
Main Methods:
- A cohort of 2330 participants was classified into four groups: control, isolated hypertension, isolated hyperhomocysteinemia, and H-type hypertension.
- Plasma total homocysteine levels were measured, and ECAS was assessed using carotid duplex sonography.
- Cox regression analysis was employed to evaluate the association between H-type hypertension and ECAS incidence.
Main Results:
- At baseline, 608 participants had H-type hypertension.
- Over a two-year follow-up, 250 (10.73%) participants developed asymptomatic ECAS.
- H-type hypertension was identified as an independent risk factor for asymptomatic ECAS (RR 3.16, 95% CI 2.00-5.00) after adjusting for confounders.
Conclusions:
- H-type hypertension is a significant independent risk factor for the development of asymptomatic ECAS.
- These findings underscore the importance of managing H-type hypertension for preventing carotid atherosclerosis.
- Targeting H-type hypertension may offer a novel therapeutic strategy for reducing ECAS prevalence.
Abstract:
Asymptomatic extracranial artery stenosis (ECAS) is a well-known risk factor for stroke and H-type hypertension, which is defined as hypertension with hyperhomocysteinemia, is associated with cardio-cerebrovascular diseases. However, the impact of H-type hypertension on ECAS is mostly unknown. We designed this study to investigate the association between H-type hypertension and prevalence of ECAS. We included 2330 participants in this study and classified them into four groups: the control group without hypertension or hyperhomocysteinemia, isolated hypertension group, isolated hyperhomocysteinemia group and H-type hypertension group. We measured the baseline plasma total homocysteine levels and assessed ECAS by carotid duplex sonography twice at baseline and during follow up. We used a Cox regression model to analyse the association between H-type hypertension and ECAS. At baseline, 608 subjects suffered from H-type hypertension. Within two years of follow-up, asymptomatic ECAS occurred in 250 (10.73%) participants. After adjusting for relevant risk factors, we found H-type hypertension to be an independent risk factor for asymptomatic ECAS (relative risk (RR) 3.16, 95% confidence interval (95% CI) 2.00-5.00). Our findings provide direct evidence for the importance of H-type hypertension in the occurrence of ECAS and as a potential therapeutic target for carotid atherosclerosis.
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