Morning hypertension is a risk factor of macrovascular events following cerebral infarction: A retrospective study
Qinhua Wu1, Jianfeng Qu, Yong Yin
1Department of Neurology, Fengxian Branch, Shanghai Jiaotong University Affiliated 6th People's Hospital, Shanghai, China.
Insights
Morning hypertension, dyslipidemia, and inflammatory infections increase macrovascular event risk after cerebral infarction. Improving blood pressure control and medication adherence can mitigate these risks.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Cerebral infarction survivors face risks of macrovascular events.
- Identifying modifiable risk factors is crucial for secondary prevention.
Purpose of the Study:
- To investigate risk factors for macrovascular events post-cerebral infarction.
- To identify independent risk and protective factors for improved patient outcomes.
Main Methods:
- Retrospective study of 702 cerebral infarction patients.
- Comparison between patients with (n=122) and without (n=580) macrovascular events.
- Multivariable analysis to determine independent risk and protective factors.
Main Results:
- Morning hypertension, dyslipidemia, and inflammatory infections were independent risk factors (ORs 1.75, 1.71, 2.26 respectively).
- Antithrombotic and statin compliance were protective factors (ORs 0.49, 0.64 respectively).
- Morning heart rate was also a protective factor (OR 0.977).
Conclusions:
- Morning hypertension, dyslipidemia, and inflammatory infections elevate macrovascular event risk post-cerebral infarction.
- Enhanced morning blood pressure management and medication adherence (antithrombotics, statins) are vital for secondary prevention.
Abstract:
This study aimed to investigate risk factors (such as morning hypertension, drug compliance, and biochemical parameters) of macrovascular events after cerebral infarction.This was a retrospective study of patients with cerebral infarction admitted between May 2015 and April 2016 at the Fengxian Branch, 6th People's Hospital of Shanghai. They were divided into the macrovascular events and control groups according to the diagnosis of macrovascular events following cerebral infarction.Among the 702 patients included for analysis, 122 patients were with macrovascular events and 580 were without macrovascular events (controls). Morning hypertension (P = .01), dyslipidemia (P = .007), atrial fibrillation (P = .039), carotid artery plaque (P = .014), inflammatory infection (P = .005), high homocysteine (P = .032), antithrombotic compliance (P < .001), statins compliance (P < .001), morning diastolic blood pressure (P < .001), morning systolic blood pressure (P < .001), and morning heart rate (morHR) (P = .033) were associated with macrovascular events. Multivariable analysis showed that morning hypertension (P = .021, odds ratio [OR] = 1.753, 95% confidence interval [CI] [1.088, 2.826]), dyslipidemia (P = .021, OR = 1.708, 95% CI [1.085, 2.687]), and inflammatory infection (P = .031, OR = 2.263, 95% CI [1.078, 4.752]) were independent risk factors for macrovascular events, while antithrombotic compliance (P < .001, OR = 0.488, 95% CI [0.336, 0.709]), statin compliance (P = .02, OR = 0.64, 95% CI [0.44, 0.931]), and morHR (P = .027, OR = 0.977, 95% CI [0.958, 0.997]) were independent protective factors against macrovascular events. Atrial fibrillation showed a tendency to be associated with macrovascular events (P = .077, OR = 1.531, 95% CI [0.955, 2.454]).Morning hypertension, dyslipidemia, and inflammatory infection may increase the risk of macrovascular events following cerebral infarction. Improving morning blood pressure management and drug compliance (antithrombotic drugs and statins) may reduce the risk of macrovascular events following cerebral infarction.
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