Dose-response relationship between blood pressure and intracranial atherosclerotic stenosis
Hong-Qi Li1, Xun Wang1, Hui-Fu Wang2
1Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Insights
Elevated blood pressure significantly increases the risk of intracranial atherosclerotic stenosis (ICAS). Higher systolic and pulse pressures are linked to a greater ICAS burden in the Chinese population.
Area of Science:
- Neurology
- Cardiovascular Science
- Public Health
Background:
- Intracranial atherosclerotic stenosis (ICAS) is a significant cause of stroke.
- Understanding the relationship between blood pressure and ICAS is crucial for prevention strategies.
Purpose of the Study:
- To investigate the association between blood pressure levels and the risk and burden of ICAS.
- To analyze these associations within the Chinese population.
Main Methods:
- A large-scale, multi-center, case-control study was conducted.
- 1055 ICAS patients and 1296 controls were analyzed.
- Intracranial arteries were evaluated using advanced imaging techniques (MRA, CTA, DSA).
Main Results:
- Increased systolic, diastolic, and pulse pressure were significantly associated with higher odds of ICAS.
- Each 10 mmHg increase in systolic, diastolic, and pulse pressure correlated with a 32%, 28%, and 35% increased odds of ICAS, respectively.
- Higher systolic and pulse pressures were also linked to an increased ICAS burden.
Conclusions:
- Blood pressure components (systolic, diastolic, pulse pressure) show a dose-response relationship with ICAS risk.
- Elevated systolic and pulse pressures contribute to a greater ICAS burden, highlighting the importance of blood pressure management.
Background And Aims:
We aimed to explore the association between blood pressure, intracranial atherosclerotic stenosis (ICAS) risks and ICAS burden in the Chinese population.
Methods:
A retrospective hospital-based multi-center case-control study with large sample size was conducted. 1055 ICAS patients and 1296 non-ICAS subjects with complete clinical information and intracranial artery evaluation were identified between 2014 and 2019. Cerebral arteries were evaluated by magnetic resonance angiography, and/or computed tomography, and/or digital subtraction angiography. Two or more neurologists were involved in reading and assessment of images. The association between ICAS and burden of ICAS with blood pressure was evaluated with univariate logistic models and multivariate logistic models.
Results:
With every increase of 10 mmHg in systolic blood pressure, diastolic blood pressure and pulse pressure, the odds of ICAS increased by 32%, 28% and 35% in multivariate analysis, respectively (odds ratio = 1.32, 1.28, and 1.35 respectively, all p < 0.001). Similarly, every increment of 10 mmHg in systolic blood pressure and pulse pressure was associated with an increased risk of ICAS burden (each odds ratio = 1.08, p < 0.05).
Conclusions:
Systolic blood pressure, diastolic blood pressure, and pulse pressure were associated with the risk of ICAS in a dose-response manner. Moreover, higher systolic blood pressure and pulse pressure could lead to higher ICAS burdens.
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