High Blood Pressure Increases the Risk of Poor Outcome at Discharge and 12-month Follow-up in Patients with Symptomatic Intracranial Large Artery Stenosis and Occlusions: Subgroup analysis of the CICAS Study

Authors

Dan-Dan Yu, Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yue-Hua Pu, Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yue-Song Pan, Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xin-Ying Zou, Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yannie Soo, Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Thomas Leung, Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Li-Ping Liu, Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
David Z. Wang, OSF Saint Francis Medical Center, Illinois Neurological Institute, Peoria, IL, USA.Follow
Ka-Sing Wong, Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Yi-Long Wang, Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yong-Jun Wang, Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Document Type

Article

Abstract

AIMS: The purpose of this study was to discuss the relationship between blood pressure and prognosis of patients with symptomatic intracranial arterial stenosis. METHODS: Data on 2426 patients with symptomatic intracranial large artery stenosis and occlusion who participated in the Chinese Intracranial Atherosclerosis (CICAS) study were analyzed. According to the JNC 7 criteria, blood pressure of all patients was classified into one of the four subgroups: normal, prehypertension, hypertension stage I, and hypertension stage II. Poor outcomes were defined as death and functional dependency (mRS 3-5) at discharge or at 1 year. RESULTS: For patients with intracranial stenosis of 70% to 99%, the rate of poor outcome at discharge was 19.3%, 23.5%, 26.8%, and 39.8% (P = 0.001) for each blood pressure subgroup. For patients with intracranial large artery occlusion, the rates were 17.6%, 22.1%, 29.5%, and 49.8%, respectively (P < 0.0001). The rate of poor outcome at 12-month follow-up was 12.6%, 15.3%, 28.5%, and 27.9% (P = 0.0038) in patients with stenosis of 70% to 99% for each blood pressure subgroup and 11.6%, 21.5%, 23.9%, 35.1% (P < 0.0001) in patients with occlusion. CONCLUSIONS: For patients with severe intracranial arterial stenosis or occlusion, higher hypertension stages are associated with an increased risk of poor outcome at discharge and 12-month follow-up.

Medical Subject Headings

Aged; Arterial Occlusive Diseases (epidemiology, therapy); Blood Pressure (physiology); China (epidemiology); Cohort Studies; Constriction, Pathologic; Female; Humans; Hypertension (diagnosis, etiology); Intracranial Arteriosclerosis (classification, complications, diagnosis, epidemiology); Male; Middle Aged; Patient Discharge; Randomized Controlled Trials as Topic; Risk Factors; Treatment Outcome

Publication Date

6-1-2015

Publication Title

CNS neuroscience & therapeutics

E-ISSN

1755-5949

Volume

21

Issue

6

First Page

530

Last Page

5

PubMed ID

25917332

Digital Object Identifier (DOI)

10.1111/cns.12400

Recommended Citation

Yu, Dan-Dan; Pu, Yue-Hua; Pan, Yue-Song; Zou, Xin-Ying; Soo, Yannie; Leung, Thomas; Liu, Li-Ping; Wang, David Z.; Wong, Ka-Sing; Wang, Yi-Long; and Wang, Yong-Jun, "High Blood Pressure Increases the Risk of Poor Outcome at Discharge and 12-month Follow-up in Patients with Symptomatic Intracranial Large Artery Stenosis and Occlusions: Subgroup analysis of the CICAS Study" (2015). Neurology. 1789.
https://scholar.barrowneuro.org/neurology/1789