Wang D, Zhou Y, Guo Y, Wang C, Wang A, Jin Z, Gao X, Wu S, Zhao X, Jonas J B
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Eur J Neurol. 2015 Mar;22(3):533-9. doi: 10.1111/ene.12611. Epub 2014 Dec 16.
Since it has remained unclear whether arterial pre-hypertension is a risk factor for cerebrovascular diseases, potential associations between arterial pre-hypertension and intracranial arterial stenosis (ICAS) and extracranial arterial stenosis (ECAS) were assessed.
The population-based Asymptomatic Polyvascular Abnormalities in Community Study was a sub-study of employees and retirees of the coal mining industry in China. Our study examined asymptomatic polyvascular abnormalities in a general population and with an age of 40+ years without history of stroke, transient ischaemic attacks and coronary heart disease. ICAS was diagnosed by transcranial Doppler sonography and was defined by peak flow velocity criteria; ECAS was diagnosed by carotid duplex sonography and was defined by the diameter of the common carotid artery or internal carotid artery.
Out of 4422 study participants, 711 (16.1%) subjects showed an asymptomatic ICAS and 292 (6.6%) showed an asymptomatic ECAS. After adjusting for relevant risk factors, higher prevalence of ICAS was significantly associated with higher prevalence of pre-hypertension [odds ratio (OR) 1.55; 95% confidence interval (CI) 1.11, 2.16; P = 0.010] and hypertension (OR 1.80; 95% CI 1.53, 2.11; P < 0.001). Stratified by gender, the association was stronger for men than for women. Asymptomatic ECAS was not significantly associated with the prevalence of pre-hypertension (OR 0.78; 95% CI 0.55, 1.10) or of hypertension (OR 1.06; 95% CI 0.91, 1.24).
The results suggest that arterial pre-hypertension in addition to hypertension is associated with a higher prevalence of asymptomatic ICAS, more in men.
由于动脉前期高血压是否为脑血管疾病的危险因素仍不明确，因此对动脉前期高血压与颅内动脉狭窄（ICAS）和颅外动脉狭窄（ECAS）之间的潜在关联进行了评估。
基于人群的社区无症状多血管异常研究是对中国煤炭行业员工和退休人员的一项子研究。我们的研究在年龄40岁及以上、无中风、短暂性脑缺血发作和冠心病病史的普通人群中检查无症状多血管异常情况。ICAS通过经颅多普勒超声诊断，并根据峰值流速标准进行定义；ECAS通过颈动脉双功超声诊断，并根据颈总动脉或颈内动脉直径进行定义。
在4422名研究参与者中，711名（16.1%）受试者存在无症状ICAS，292名（6.6%）存在无症状ECAS。在对相关危险因素进行校正后，ICAS的较高患病率与前期高血压的较高患病率显著相关[比值比（OR）1.55；95%置信区间（CI）1.11，2.16；P = 0.010]以及高血压的较高患病率相关（OR 1.80；95% CI 1.53，2.11；P < 0.001）。按性别分层后，男性的这种关联比女性更强。无症状ECAS与前期高血压患病率（OR 0.78；95% CI 0.55，1.10）或高血压患病率（OR 1.06；95% CI 0.91，1.24）无显著关联。
结果表明，除高血压外，动脉前期高血压与无症状ICAS的较高患病率相关，男性更为明显。
