Intracranial Artery Stenosis In Relation To Blood Pressure Components
Introduction: Vascular aging is characterized by structural and functional changes in blood vessels that lead to reduced perfusion pressure to distal organs and high blood pressure (BP). Cerebrovascular aging is strongly associated with high BP, however, systemic BP is constituted by the steady and pulsatile components. We aimed this study to investigate the association of intracranial artery stenosis in relation to the steady and pulsatile components of the systemic BP - such association remains undocumented.
Methods: We used cross-sectional data from 292 participants from the Maracaibo Aging Study who underwent ambulatory BP monitoring, magnetic resonance angiography, and MRI between 2011 to 2016. The stenosis of eleven intracranial arteries was measured using magnetic resonance angiography scans and encompassed the right and left sides of the anterior (ACA), middle (MCA), posterior (PCA) cerebral arteries, and internal carotid arteries (ICA), vertebral arteries, and the basilar artery. The steady BP component included the 24-hour mean arterial pressure (MAP) while the pulsatile component included the 24-hour pulse pressure (PP). We performed multivariable logistic regression models to assess the association between intracranial artery stenosis and BP components. Models were accounted for age, sex, head circumference, years of education, body mass index, total and high-density cholesterol ratio, creatinine, diabetes mellitus, and antihypertensive treatments.
Results: Mean age was 57.5±11 years, 75% women. After adjustment for confounders, 24-hour pulse pressure was associated (P≤ 0.020) with the stenosis of ICA (Odds ratios [OR], 2.00 per every 5 mmHg of PP; 95% confidence interval [CI], 1.49-2.69), ACA (OR, 1.50; 95% CI, 1.23-1.84), MCA (OR, 1.46; 95%, CI, 1.21-1.77), PCA (OR, 1.55; 95% CI, 1.26-1.91), basilar artery (OR, 1.28; 95% CI, 1.03-1.59) and vertebral arteries (OR, 1.42; 95% CI, 1.14-1.78). The ORs of ICA, ACA, MCA, PCA, basilar artery, and vertebral arteries in relation to high 24-hour MAP levels (P≤ 0.040) ranged from 1.27 (95% CI, 1.00-1.61) to 1.48 (95% CI, 1.15 - 1.91).
Conclusion: Elevated levels in the steady and pulsatile components of the systemic BP are associated with intracranial artery stenosis.
Patil, D., Gutierrez, J., Mena, L., Reinier, L., Chávez, C., Silva, E., ... & Zhang, Z. (2023). Abstract WP138: Intracranial Artery Stenosis In Relation To Blood Pressure Components. Stroke, 54(Suppl_1), AWP138-AWP138. https://doi.org/10.1161/str.54.suppl_1.WP138
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