title: Assessment of Risk of Aneurysmal Rupture in Patients with Normotensives, Controlled Hypertension, and Uncontrolled Hypertension.
abstract: BACKGROUND
  The prevalence of hypertension in patients with intracranial aneurysms has been an increased concern, but it is not well understood if uncontrolled hypertension has impact on aneurysmal rupture. The aim of this study was to determine whether the risk of aneurysmal rupture is higher in uncontrolled hypertensive cohorts than in controlled hypertensive cohorts and normotensive cohorts.
  
  
  METHODS
  We retrospectively analyzed the records and angiographies of 456 patients with aneurysms who were treated at our center between June 2013 and June 2014. Three groups of patients were included in the study following the ESH-ESC (European Society of Hypertension-European Society of Cardiology) 2013 guidelines: normotensive group (n = 229), controlled hypertension group (n = 127), and uncontrolled hypertension group (n = 100). Paired comparisons of these 3 groups were analyzed with the Nemenyi test. Multivariate logistic regression analysis was used to exclude the impact of possible confounding factors.
  
  
  RESULTS
  The results of the univariate analysis showed that hypertension, smoking, and size of the aneurysms were significantly associated with intracranial aneurysmal rupture (P < .05). The multivariate logistic regression analysis containing clinical and aneurysmal characteristics showed that uncontrolled hypertension, smoking, and aneurysm size were statistically significant predictors of intracranial aneurysmal rupture (P < .05). The paired comparisons of 3 groups showed that the risk of rupture of intracranial aneurysms in the uncontrolled hypertension group was significantly greater than that in the normotensive group (P < .05) and in the controlled hypertension group (P < .05).
  
  
  CONCLUSIONS
  Uncontrolled hypertension is associated with increased risk of rupture of intracranial aneurysms. Given that aneurysmal rupture is a potentially fatal-but preventable-complication, these findings are of clinical relevance.
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Zenghui
authors.initials: Z
authors.lastname: Qian
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Huibin
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, The 309th Hospital of PLA, Beijing, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Tang
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Chuhan
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhongxue
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: lyx_ttyy@163.com.
authors.forename: Youxiang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: liuaihuadoctor@163.com.
authors.forename: Aihua
authors.initials: A
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002533:Cerebral Angiography; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D020299:Intracranial Hemorrhage, Hypertensive / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents
keywords: Controlled; hypertension; intracranial aneurysm; rupture risk