Correlation Between The Severity Of Cerebral Artery Stenosis And Blood Pressure Levels

Background:Cerebral artery stenosis(CAS)refers to the narrowing or even occlusion of the lumen of cerebral arteries due to the vascular malformation,atherosclerosis,etc.it is an independent risk factor for ischemic stroke.Hypertension is one of the most common cardiovascular diseases.With the improvement of the medical technology,many drugs and even surgery can be used to lower blood pressure.But the overall control rate of the blood pressure is still very low around our country.At present,the interrelationship between CAS and hypertension is not well understood,and it is not uncommon to see patients with CAS combined with hypertension in clinical practice.Object:The purpose of the paper is to explore the correlation between the severity of CAS and blood pressure levels.Method:422 patients who underwent computed tomography angiography(CTA)examination at the Second Affiliated Hospital of Nanchang University were selected,and blood pressure measurements,biochemical indices and general clinical data were collected.In this study,to better assess the severity of CAS,we propose a new clinical and imaging-based index,the cerebral stenosis index(CSI),which quantifies the degree of stenosis of the entire large cerebral arteries by superimposing the degree of stenosis of each cerebral artery.Result:More patients in the CAS group(N=312)had combined hypertension than in the no-stenosis group(N=110)(84.9% vs 65.5%,P<0,001).After calculating the CSI for each patient,we found that the higher the CSI values the higher the systolic blood pressure,but no significant change in diastolic blood pressure was observed.The systolic blood pressure levels were 135.2mm Hg,142.7mm Hg,149.3mm Hg and152.9mm Hg and the diastolic blood pressure levels were 84.0mm Hg,82.9mm Hg,83.8mm Hg and 84.8mm Hg in the no-stenosis group,the group of CSI<4,the group of4 ≤CSI<11 and the group of CSI ≥11,respectively.Spearman analysis found that systolic blood pressure was positive correlated with CSI,age,fasting blood glucose and total cholesterol.Multiple linear regression analysis showed that CSI,age and fasting blood glucose were a positive predictor of systolic blood pressure.The logistics regression analysis suggested that CSI values was an independent risk factor for hypertension,and adjusted the confounders such as age,sex,smoking,diabetes and high-density lipoprotein,etc.,the risk of hypertension was 1.26 times(OR=1.26,95%CI [0.65,2.44],P=0.496)in the group of CSI<4,2.13 times(OR=2.13,95%CI[0.98,4.59],P=0.054)in the group of 4 ≤CSI<11 and 2.47 times(OR=2.47,95% CI[1.04,5.84],P=0.04)in the group of CSI ≥11,respectively.In addition,after statistics on the use of antihypertensive drugs,we found that the number of antihypertensive drugs taken by the patients increased with the increased of CSI values.Conclusion:The severity of CAS was positively correlated with systolic blood pressure levels and was not significant altered with diastolic blood pressure levels.Severe CAS is an independent risk factor for hypertension,as are age,smoking and diabetes mellitus.