Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2019
The effect of stenting on blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis.
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Che Wuqiang, Dong Hui, Jiang Xiongjing, Xiong Hongliang, Chen Yang, Zou Yubao, Xu Bo, Gao Runlin
Аннотация
OBJECTIVE: This study aimed to evaluate the effect of stenting on blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis.
BACKGROUND: Whether posterior circulation revascularization could reduce blood pressure in hypertensive patients with posterior circulation hypoperfusion has not been investigated in humans.
METHODS: A total of 48 patients with essential hypertension (33 males; mean age 63.0 ± 8.7 years) with symptomatic proximal subclavian or vertebral artery stenosis who underwent stenting successfully at the Fuwai Hospital were prospectively enrolled between January 2014 and December 2015. All 48 patients were followed up at 1, 3, and 6 months after the procedure. Blood pressure, use of antihypertensive agents, and complications were investigated.
RESULTS: Baseline values included office blood pressure of 132/77 ± 10/8 mmHg, mean 24-hr blood pressure of 127/75 ± 12/9 mmHg, and mean antihypertensive agents used of 1.6 ± 0.8. Stenosis of the subclavian and vertebral arteries decreased from 88.9 ± 9.5% and 85.8 ± 7.4% to 5.5 ± 3.5% and 4.6 ± 3.7%, respectively, immediately after the procedure. Reductions in office blood pressure were - 7/-3 (SD 3/2), -9/-4 (5/3), and - 10/-5 (7/5) mmHg at 1, 3, and 6 months, respectively. While 24-hr blood pressures after the procedure reduced by -5/-3 mmHg at 6 months, the total number of antihypertensive agents used at the aforementioned time points was unchanged.
CONCLUSION: This first prospective cohort study in humans showed that posterior circulation stenting is apparently effective in reducing blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis.
BACKGROUND: Whether posterior circulation revascularization could reduce blood pressure in hypertensive patients with posterior circulation hypoperfusion has not been investigated in humans.
METHODS: A total of 48 patients with essential hypertension (33 males; mean age 63.0 ± 8.7 years) with symptomatic proximal subclavian or vertebral artery stenosis who underwent stenting successfully at the Fuwai Hospital were prospectively enrolled between January 2014 and December 2015. All 48 patients were followed up at 1, 3, and 6 months after the procedure. Blood pressure, use of antihypertensive agents, and complications were investigated.
RESULTS: Baseline values included office blood pressure of 132/77 ± 10/8 mmHg, mean 24-hr blood pressure of 127/75 ± 12/9 mmHg, and mean antihypertensive agents used of 1.6 ± 0.8. Stenosis of the subclavian and vertebral arteries decreased from 88.9 ± 9.5% and 85.8 ± 7.4% to 5.5 ± 3.5% and 4.6 ± 3.7%, respectively, immediately after the procedure. Reductions in office blood pressure were - 7/-3 (SD 3/2), -9/-4 (5/3), and - 10/-5 (7/5) mmHg at 1, 3, and 6 months, respectively. While 24-hr blood pressures after the procedure reduced by -5/-3 mmHg at 6 months, the total number of antihypertensive agents used at the aforementioned time points was unchanged.
CONCLUSION: This first prospective cohort study in humans showed that posterior circulation stenting is apparently effective in reducing blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis.