Journal of the neurological sciences · 2024
Long-term changes in carotid intima-media thickness according to baseline blood pressure level: J-STARS Echo study.
Клиническое исследование III фазыСтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Wada Shinichi, Koga Masatoshi, Kagimura Tatsuo, Toyoda Kazunori, Nagai Yoji, Aoki Shiro, Nezu Tomohisa, Hosomi Naohisa, Origasa Hideki, Ohtsuki Toshiho, Maruyama Hirofumi, Yasaka Masahiro, Kitagawa Kazuo, Uchiyama Shinichiro, Minematsu Kazuo, Matsumoto Masayasu, Japan Statin Treatment Against Recurrent Stroke (J-STARS) Echo Study Collaborators
Аннотация
BACKGROUND AND AIMS: We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients.
METHODS: Patients aged 45-80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140 mmHg and diastolic BP [dBP] <90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients). Mixed effect models were used to examine differences in slope of mean carotid IMT increases annually over the 5-year observation period among three groups, and for two groups divided based on whether they were above or below certain BP cut-off levels set at every 1 mmHg, ranging between 139 and 161 mmHg for sBP, and 89-101 mmHg for dBP.
RESULTS: Of 792 patients, baseline mean carotid IMT in the G1-group (0.908 ± 0.152 mm) and G2-group (0.905 ± 0.145 mm) was significantly higher than the N-group (0.870 ± 0.153 mm) (P < 0.01, for both respectively). Although there was no significant difference in the increase among three groups (P = 0.091), the increase in patients above sBP 154, 159 and 160 mmHg or dBP 101 mmHg at baseline was higher than others (P < 0.05 for all).
CONCLUSIONS: High baseline BP correlated with a high baseline carotid IMT and its subsequent 5-year increase in non-cardioembolic stroke patients.
CLINICAL TRIAL REGISTRATION: http://www.
CLINICALTRIALS: gov.
UNIQUE IDENTIFIER: NCT00361530.
METHODS: Patients aged 45-80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140 mmHg and diastolic BP [dBP] <90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients). Mixed effect models were used to examine differences in slope of mean carotid IMT increases annually over the 5-year observation period among three groups, and for two groups divided based on whether they were above or below certain BP cut-off levels set at every 1 mmHg, ranging between 139 and 161 mmHg for sBP, and 89-101 mmHg for dBP.
RESULTS: Of 792 patients, baseline mean carotid IMT in the G1-group (0.908 ± 0.152 mm) and G2-group (0.905 ± 0.145 mm) was significantly higher than the N-group (0.870 ± 0.153 mm) (P < 0.01, for both respectively). Although there was no significant difference in the increase among three groups (P = 0.091), the increase in patients above sBP 154, 159 and 160 mmHg or dBP 101 mmHg at baseline was higher than others (P < 0.05 for all).
CONCLUSIONS: High baseline BP correlated with a high baseline carotid IMT and its subsequent 5-year increase in non-cardioembolic stroke patients.
CLINICAL TRIAL REGISTRATION: http://www.
CLINICALTRIALS: gov.
UNIQUE IDENTIFIER: NCT00361530.