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双臂血压差值与高血压患者无症状颅内和颅外动脉狭窄的相关性。

Association of Inter-arm Blood Pressure Difference with Asymptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients.

机构信息

Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

Sci Rep. 2016 Jul 14;6:29894. doi: 10.1038/srep29894.

Abstract

Inter-arm blood pressure (BP) difference has been associated with ischemic stroke. Local atherosclerosis of stroke differ among vulnerable individuals, whereas intracranial arterial stenosis (ICAS) is more frequently affected Asians, and extracranial arterial stenosis (ECAS) is more prevalent among whites. We hereby sought to explore the association of inter-arm BP difference with ICAS and ECAS in stroke-free hypertensive patients in Chinese population. All the 885 subjects were evaluated of ICAS and ECAS through computerized tomographic angiography. Both arm BP was measured simultaneously by Vascular Profiler-1000 device. In the continuous study, ICAS was significantly associated with age, male, average brachial SBP, diabetes, anti-hypertensive treatment and inter-arm DBP difference. ECAS was associated with age, inter-arm SBP and LDL. In the categorical study, subjects with the top quartile of inter-arm DBP difference (≥4 mmHg) showed significantly higher risk of ICAS (OR = 2.109; 95% CI, 1.24-3.587). And the participants with the top quartile of inter-arm SBP difference (≥6 mmHg) showed significantly higher risk of ECAS (OR = 2.288; 95% CI, 1.309-3.998). In conclusion, we reported a diverse association of inter-arm SBP/DBP difference with the ICAS/ECAS. Inter-arm DBP difference might be the early symbol of ICAS in Chinese population, which need further verification in long-term cohort study.

摘要

双臂血压差值与缺血性脑卒中有关。易患个体的卒中局部动脉粥样硬化情况存在差异,而颅内动脉狭窄(ICAS)在亚洲人群中更为常见,颅外动脉狭窄(ECAS)在白种人群中更为常见。本研究旨在探讨中国人群中无卒中的高血压患者双臂血压差值与 ICAS 和 ECAS 的相关性。所有 885 例患者均通过计算机断层血管造影术评估 ICAS 和 ECAS。同时使用 Vascular Profiler-1000 设备测量双臂血压。在连续研究中,ICAS 与年龄、男性、平均肱动脉收缩压、糖尿病、降压治疗和双臂舒张压差值显著相关。ECAS 与年龄、双臂收缩压和 LDL 相关。在分类研究中,双臂舒张压差值最高四分位数(≥4mmHg)的患者 ICAS 风险显著升高(OR=2.109;95%CI,1.24-3.587)。双臂收缩压差值最高四分位数(≥6mmHg)的患者 ECAS 风险显著升高(OR=2.288;95%CI,1.309-3.998)。总之,我们报告了双臂收缩压/舒张压差值与 ICAS/ECAS 之间的不同相关性。双臂舒张压差值可能是中国人群 ICAS 的早期标志,需要在长期队列研究中进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e786/4944122/e9ad8722a287/srep29894-f1.jpg

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