Intracranial Atherosclerosis and Stage 1 Hypertension Defined by the 2017 ACC/AHA Guideline. (21st August 2019)

• Record Type: Journal Article
• Authors: Nam, Ki-Woong; Kwon, Hyung-Min; Jeong, Han-Yeong; Park, Jin-Ho; Kwon, Hyuktae; Jeong, Su-Min
• Is Part Of: American journal of hypertension. Volume 33:Number 1(2020)
• Page Start: 92
• Page End: 98
• Publication Date: 2019-08-21
• Subjects: atherosclerosis -- blood pressure -- cerebrovascular disease -- hypertension -- prehypertension; Hypertension -- Periodicals; 616.132005
• DOI: 10.1093/ajh/hpz138
• Languages: English
• ISSNs: 0895-7061

Abstract

Abstract: Background: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new, stricter definition of stage 1 hypertension which was previously considered prehypertension. However, impacts of the novel stage 1 hypertension on deleterious target-organ outcomes are still controversial. In this study, we evaluated the relationship between this newly defined stage 1 hypertension and the presence of intracranial atherosclerosis (ICAS) lesions in neurologically healthy participants. Methods: We assessed consecutive participants in routine health checkups between January 2006 and December 2013. Blood pressure (BP) was classified according to the 2017 ACC/AHA hypertension guideline, and ICAS was defined as occlusion or ≥50% stenosis of intracranial vessels on flight magnetic resonance angiography. Results: Among 3, 111 healthy participants (mean age: 56 years, sex: 54% men), 85 (3%) had ICAS lesions. In multivariate analysis, stage 1 hypertension (adjusted odds ratio: 2.46, 95% confidence interval: 1.10–5.51, P = 0.029) remained an independent predictor of ICAS after adjustment for confounders. Stage 2 hypertension showed a higher odds ratio and a lower P value, indicating a dose–response effect. Age and HbA1c level were also significantly associated with ICAS, independent of the BP categories. The ICAS lesion burden showed a dose–response effect across the BP categories ( P for trend <0.001), whereas ICAS lesion location did not ( P for trend = 0.699). Conclusions: We demonstrated that stage 1 hypertension, defined according to the 2017 ACC/AHA guideline, was associated with a higher prevalence and burden of ICAS lesions in a neurologically healthy population.