Key result
Higher cf-PWV is linked to ~51% higher odds of asymptomatic ICLAD per SD in hypertension.
Why the study?
Little is known about the association between intracranial large artery disease and large arterial stiffness in hypertensive patients without stroke.
Is increased arterial stiffness associated with asymptomatic intracranial large arterial stenosis and calcification in untreated hypertensive patients?
Cross-Sectional (n=270)
No
Is increased arterial stiffness associated with asymptomatic intracranial large arterial stenosis and calcification in untreated hypertensive patients?
Odds Ratio: 1.51 (95% CI 1.09–2.1)
Increased arterial stiffness, as measured by cf-PWV and 24-h PP, is independently associated with asymptomatic intracranial large artery disease in untreated hypertensive patients.
May support stiffness assessment in hypertension risk evaluation; leaves open causal role and need for prospective outcome trials.
BACKGROUND: Intracranial large artery disease (ICLAD), such as stenosis and calcification, is common in Chinese patients with stroke. However, little is known about ICLAD and its association with large arterial stiffness in hypertensive patients. METHODS: We recruited 270 (mean age 61.0 years, 45.6% male) untreated hypertensive patients without stroke from a community in Shanghai, China. ICLAD was detected by computerized tomographic angiography (CTA). Carotid-femoral pulse wave velocity (cf-PWV), office, and 24-h ambulatory pulse pressure (PP) as well as ambulatory arterial stiffness index (AASI) were determined as the measures of arterial stiffness. RESULTS: Among all participants, 26 (9.6%) had concurrent intracranial arterial stenosis and calcification, 11 (4.1%) stenosis only, and 71 (26.3%) calcifications only. After adjustment for age, mean arterial pressure, and other covariables, there was significant difference in cf-PWV (13.1 vs. 13.7 vs. 15.0 m/s; P = 0.0015) and 24-h PP (46.7 vs. 48.8 vs. 55.7 mm Hg; P = 0.0007) between patients with normal vessels (n = 162), with stenosis or calcification (n = 82), and with both lesions (n = 26). Multiple ordinal logistic regression analyses showed that both cf-PWV and 24-h PP were independently associated with ICLAD. Odds ratios (95% confidence interval (CI)) of ICLAD after multivariable and mutually adjustment were 1.51 (1.09-2.10) and 1.46 (1.06-2.01) for 1-s.d. increase in cf-PWV and 24-h PP, respectively. No significant association (P ≥ 0.10) with AASI or office PP was observed in multivariable analysis. CONCLUSION: Increased arterial stiffness was independently associated with ICLAD. cf-PWV and 24-h PP might be useful in identifying those more likely to have ICLAD among hypertensive patients.
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Zhang et al. (2010) conducted a cross-sectional in Hypertension (n=270). Increased arterial stiffness (cf-PWV) vs. Lower arterial stiffness was evaluated on Intracranial large artery disease (ICLAD) (OR 1.51, 95% CI 1.09-2.10). A 1-SD increase in carotid-femoral pulse wave velocity was independently associated with higher odds of asymptomatic intracranial large artery disease in hypertensive patients (OR 1.51; 95% CI 1.09-2.10).
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