血圧と脳卒中再発の関係 内動脈狭窄症の患者における血圧と脳卒中再発の関係
Tanya N Turan1, George Cotsonis, Michael J Lynn
1Emory University, Atlanta, GA, USA. tturan@emory.edu
Circulation
|May 23, 2007
まとめ
高血圧は,頭蓋内狭窄症の患者の脳卒中リスクを高めます. この研究は,高血圧を高血圧を防ぐために許すという一般的な慣行に異議を唱え,実際に脳卒中リスクを高める可能性があることを示唆しています.
科学分野:
- 神経学 神経学とは
- 心血管医学 心血管医学
- 脳卒中研究 卒中研究
背景:
- 臨床医は,ヒポパーフュージョンを防ぐために,脳内狭窄症の患者の高血圧を維持することがよくあります.
- 脳卒中のリスクを減らすためのこの慣行の有効性は議論されています.
研究 の 目的:
- 頭蓋内狭窄症の患者における高血圧と脳卒中のリスクとの関連を調査する.
- この集団における高血圧が脳卒中を予防するか,または増加させるかどうかを判断する.
主な方法:
- ウォルファリン・アスピリン・症状性脳内疾患 (WASID) 試験の567人の患者のデータを分析した.
- 静脈動脈血圧 (SBP) と静脈動脈動脈血圧 (DBP) の平均値に基づいて,不全性脳卒中と領域性脳卒中までの時間の比較.
- 狭窄症の重度 (中等度<70%対重度>=70%) と場所による分析の階層化.
主要な成果:
- リスク要因を調整した後でも,平均SBPとDBPがより高い場合,不全性脳卒中のリスクは著しく増加しました.
- 増加したSBPとDBPは,狭窄血管の領域内の脳卒中のリスクの増加と関連していました.
- 中程度の狭窄症の患者は,SBPとDBPが上昇すると脳卒中のリスクが増加し,重度の狭窄症の患者は,DBPが上昇するとリスクが増加した.
結論:
- 高血圧は,頭蓋内狭窄症の患者において,不全性脳卒中および領域性脳卒中のリスクの増加と関連しています.
- これらの発見は,この患者グループで高血圧を維持するという一般的な臨床アプローチと矛盾しています.
- この結果は,頭蓋内狭窄症の患者では高血圧を維持すべきではないことを強く示唆しています.
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