title: Beneficial effects of prolonged blood pressure control after carotid artery stenting.
abstract: OBJECTIVE
  The main purpose of this study was to investigate whether carotid artery stenting (CAS) plus medicine in patients with severe carotid artery stenosis provide a better long-term blood pressure (BP) control compared to other medical treatments alone. The other aim was to explore the correlation between post-CAS hypotension within 6 h and long-term BP reductions after CAS.
  
  
  METHODS
  Patients with severe carotid stenosis were recruited either in the CAS group or in the medication group. BPs and the number of classes of antihypertensive agents were recorded at baseline, 6, and 12 months. Extra BP information was collected at 6 h, 3 days, and 1 month after CAS. Univariate and multivariate linear regressions were performed to test the relationship of BP changes among CAS and medication groups after 6 and 12 months of follow-up. Univariate linear regressions were also used to determine the correlations between the mean or maximal systolic BP (SBP) reductions at 6 h and 1 year post-CAS.
  
  
  RESULTS
  In total, 72 members in the CAS group and 82 members in the medication group were recruited. Compared with the medication group, patients in the CAS group had greater BP reductions at 6 and 12 months of follow-up after adjusting for confounding factors (13.56 mmHg at 6 months,P=0.0002; 16.98 mmHg at 12 months,P<0.0001). This study also shows significant positive correlations between the mean or maximal SBP reductions 6 h post-CAS and SBP reductions 1 year post-CAS (β =0.20±0.07,P=0.0067 and β =0.47±0.10,P<0.0001, respectively).
  
  
  CONCLUSIONS
  As compared to medical treatment alone, CAS may provide significant beneficial effect on long-term BP control 1 year post-CAS. Furthermore, SBP reductions 6 h post-CAS may predict the SBP reductions 1 year post-CAS.
authors.affiliation: Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei.
authors.forename: Anna
authors.initials: A
authors.lastname: Chang
authors.affiliation: Department of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei.
authors.forename: Huei-Fong
authors.initials: HF
authors.lastname: Hung
authors.affiliation: School of Public Health, College of Public Health, Taipei Medical University, Taipei.
authors.forename: Fang-I
authors.initials: FI
authors.lastname: Hsieh
authors.affiliation: Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; School of Medicine, College of Medicine, Taipei Medical University, Taipei.
authors.forename: Wei-Hung
authors.initials: WH
authors.lastname: Chen
authors.affiliation: Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; Institute of Public Health, National Yang-Ming University, Taipei.
authors.forename: Hsu-Ling
authors.initials: HL
authors.lastname: Yeh
authors.affiliation: Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
authors.forename: Jiann-Horng
authors.initials: JH
authors.lastname: Yeh
authors.affiliation: Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
authors.forename: Hou-Chang
authors.initials: HC
authors.lastname: Chiu
authors.affiliation: Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; School of Medicine, College of Medicine, Taipei Medical University, Taipei.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Lien
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology*; D016893:Carotid Stenosis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D007022:Hypotension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents
keywords: antihypertensive agents; baroreflex; carotid artery stenosis; cerebral autoregulation; hemodynamics; post-stenting hypotension