Related Experiment Video
Updated: Jan 20, 2026
Quantification of Atherosclerosis in Mice
Published on: June 12, 2019
Intracranial Atherosclerosis and Stage 1 Hypertension Defined by the 2017 ACC/AHA Guideline
Ki-Woong Nam1, Hyung-Min Kwon2, Han-Yeong Jeong1
1Department of Neurology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea.
Insights
The 2017 hypertension guidelines link stage 1 hypertension to increased intracranial atherosclerosis (ICAS) lesions. This finding highlights the importance of managing even mild high blood pressure to prevent neurological complications.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Public Health
Background:
- The 2017 ACC/AHA guidelines redefined stage 1 hypertension, previously considered prehypertension.
- The clinical impact of this new definition on target-organ damage remains under investigation.
Purpose of the Study:
- To investigate the association between the 2017 ACC/AHA defined stage 1 hypertension and intracranial atherosclerosis (ICAS) in neurologically healthy individuals.
Main Methods:
- Utilized data from 3,111 healthy participants undergoing routine health checkups (2006-2013).
- Classified blood pressure according to the 2017 ACC/AHA hypertension guideline.
- Diagnosed ICAS via flight magnetic resonance angiography, defined as ≥50% stenosis or occlusion of intracranial vessels.
Main Results:
- 85 participants (3%) had ICAS lesions.
- Stage 1 hypertension was an independent predictor of ICAS (aOR 2.46, P=0.029), with a dose-response effect observed for hypertension severity.
- Increased ICAS lesion burden correlated with higher blood pressure categories (P for trend <0.001).
Conclusions:
- Stage 1 hypertension, per the 2017 ACC/AHA guidelines, is associated with a higher prevalence and burden of ICAS lesions.
- These findings suggest that the updated hypertension definition identifies individuals at increased risk for cerebrovascular disease.
Background:
In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new, stricter definition of stage 1 hypertension which was previously considered prehypertension. However, impacts of the novel stage 1 hypertension on deleterious target-organ outcomes are still controversial. In this study, we evaluated the relationship between this newly defined stage 1 hypertension and the presence of intracranial atherosclerosis (ICAS) lesions in neurologically healthy participants.
Methods:
We assessed consecutive participants in routine health checkups between January 2006 and December 2013. Blood pressure (BP) was classified according to the 2017 ACC/AHA hypertension guideline, and ICAS was defined as occlusion or ≥50% stenosis of intracranial vessels on flight magnetic resonance angiography.
Results:
Among 3,111 healthy participants (mean age: 56 years, sex: 54% men), 85 (3%) had ICAS lesions. In multivariate analysis, stage 1 hypertension (adjusted odds ratio: 2.46, 95% confidence interval: 1.10-5.51, P = 0.029) remained an independent predictor of ICAS after adjustment for confounders. Stage 2 hypertension showed a higher odds ratio and a lower P value, indicating a dose-response effect. Age and HbA1c level were also significantly associated with ICAS, independent of the BP categories. The ICAS lesion burden showed a dose-response effect across the BP categories (P for trend <0.001), whereas ICAS lesion location did not (P for trend = 0.699).
Conclusions:
We demonstrated that stage 1 hypertension, defined according to the 2017 ACC/AHA guideline, was associated with a higher prevalence and burden of ICAS lesions in a neurologically healthy population.
Related Concept Videos
01:14Piaget's Stage 1 of Cognitive Development
Exploration...
01:26Atherosclerosis III: Management
01:30Atherosclerosis I: Introduction
01:26Guidelines for Nursing Documentation II
Timely documentation is crucial to ensure continuity of care for patients. Any delays in recording or reporting medical information can result in medical errors and even adverse patient outcomes. From medication administration to diagnostic test results, every detail must be accurately and promptly documented to provide the best possible care for patients.
01:06Legal Guidelines for Documentation
01:23Guidelines for Sketching a Curve