High Blood Pressure Increases the Risk of Poor Outcome at Discharge and 12-month Follow-up in Patients with Symptomatic Intracranial Large Artery Stenosis and Occlusions: Subgroup analysis of the CICAS Study.
OBJECTIVE
The purpose of this study was to discuss the relationship between blood pressure and prognosis of patients with symptomatic intracranial arterial stenosis.


METHODS
Data on 2426 patients with symptomatic intracranial large artery stenosis and occlusion who participated in the Chinese Intracranial Atherosclerosis (CICAS) study were analyzed. According to the JNC 7 criteria, blood pressure of all patients was classified into one of the four subgroups: normal, prehypertension, hypertension stage I, and hypertension stage II. Poor outcomes were defined as death and functional dependency (mRS 3-5) at discharge or at 1 year.


RESULTS
For patients with intracranial stenosis of 70% to 99%, the rate of poor outcome at discharge was 19.3%, 23.5%, 26.8%, and 39.8% (P = 0.001) for each blood pressure subgroup. For patients with intracranial large artery occlusion, the rates were 17.6%, 22.1%, 29.5%, and 49.8%, respectively (P < 0.0001). The rate of poor outcome at 12-month follow-up was 12.6%, 15.3%, 28.5%, and 27.9% (P = 0.0038) in patients with stenosis of 70% to 99% for each blood pressure subgroup and 11.6%, 21.5%, 23.9%, 35.1% (P < 0.0001) in patients with occlusion.


CONCLUSIONS
For patients with severe intracranial arterial stenosis or occlusion, higher hypertension stages are associated with an increased risk of poor outcome at discharge and 12-month follow-up.
Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.|Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Dan-Dan
DD
Yu
Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.|Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Yue-Hua
YH
Pu
Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.|Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Yue-Song
YS
Pan
Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.|Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Xin-Ying
XY
Zou
Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Yannie
Y
Soo
Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Thomas
T
Leung
Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.|Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Li-Ping
LP
Liu
OSF Saint Francis Medical Center, Illinois Neurological Institute, Peoria, IL, USA.
David Z
DZ
Wang
Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Ka-Sing
KS
Wong
Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.|Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Yi-Long
YL
Wang
Neuro-Intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.|Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Yong-Jun
YJ
Wang
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000628:therapy*; D001794:Blood Pressure / Q000502:physiology*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology*; D002537:Intracranial Arteriosclerosis / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome
Hypertension stage; Intracranial atherosclerosis; Ischemic stroke; Outcome; Prognosis