Beneficial effects of prolonged blood pressure control after carotid artery stenting

Anna Chang,1 Huei-Fong Hung,2 Fang-I Hsieh,3 Wei-Hung Chen,1,4 Hsu-Ling Yeh,1,5 Jiann-Horng Yeh,1,6 Hou-Chang Chiu,1,6 Li-Ming Lien1,4 1Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 2Department of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 3School of Public H...

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Autores principales:	Chang A, Hung HF, Hsieh FI, Chen WH, Yeh HL, Yeh JH, Chiu HC, Lien LM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	carotid artery stenting carotid artery stenosis blood pressure post-carotid artery stenting hypotension antihypertensive agents Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/719e172a779347d9bb99ee1ad7b7d6c7
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spelling	oai:doaj.org-article:719e172a779347d9bb99ee1ad7b7d6c72021-12-02T07:33:30ZBeneficial effects of prolonged blood pressure control after carotid artery stenting1178-1998https://doaj.org/article/719e172a779347d9bb99ee1ad7b7d6c72017-01-01T00:00:00Zhttps://www.dovepress.com/beneficial-effects-of-prolonged-blood-pressure-control--after-carotid--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Anna Chang,1 Huei-Fong Hung,2 Fang-I Hsieh,3 Wei-Hung Chen,1,4 Hsu-Ling Yeh,1,5 Jiann-Horng Yeh,1,6 Hou-Chang Chiu,1,6 Li-Ming Lien1,4 1Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 2Department of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 3School of Public Health, College of Public Health, Taipei Medical University, Taipei, 4School of Medicine, College of Medicine, Taipei Medical University, Taipei, 5Institute of Public Health, National Yang-Ming University, Taipei, 6School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan Objectives: 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. Materials and 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). Conclusion: 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. Keywords: carotid artery stenosis, hemodynamics, cerebral autoregulation, baroreflex, post-stenting hypotension, antihypertensive agentsChang AHung HFHsieh FIChen WHYeh HLYeh JHChiu HCLien LMDove Medical Pressarticlecarotid artery stentingcarotid artery stenosisblood pressurepost-carotid artery stenting hypotensionantihypertensive agentsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 103-109 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	carotid artery stenting carotid artery stenosis blood pressure post-carotid artery stenting hypotension antihypertensive agents Geriatrics RC952-954.6
spellingShingle	carotid artery stenting carotid artery stenosis blood pressure post-carotid artery stenting hypotension antihypertensive agents Geriatrics RC952-954.6 Chang A Hung HF Hsieh FI Chen WH Yeh HL Yeh JH Chiu HC Lien LM Beneficial effects of prolonged blood pressure control after carotid artery stenting
description	Anna Chang,1 Huei-Fong Hung,2 Fang-I Hsieh,3 Wei-Hung Chen,1,4 Hsu-Ling Yeh,1,5 Jiann-Horng Yeh,1,6 Hou-Chang Chiu,1,6 Li-Ming Lien1,4 1Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 2Department of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 3School of Public Health, College of Public Health, Taipei Medical University, Taipei, 4School of Medicine, College of Medicine, Taipei Medical University, Taipei, 5Institute of Public Health, National Yang-Ming University, Taipei, 6School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan Objectives: 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. Materials and 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). Conclusion: 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. Keywords: carotid artery stenosis, hemodynamics, cerebral autoregulation, baroreflex, post-stenting hypotension, antihypertensive agents
format	article
author	Chang A Hung HF Hsieh FI Chen WH Yeh HL Yeh JH Chiu HC Lien LM
author_facet	Chang A Hung HF Hsieh FI Chen WH Yeh HL Yeh JH Chiu HC Lien LM
author_sort	Chang A
title	Beneficial effects of prolonged blood pressure control after carotid artery stenting
title_short	Beneficial effects of prolonged blood pressure control after carotid artery stenting
title_full	Beneficial effects of prolonged blood pressure control after carotid artery stenting
title_fullStr	Beneficial effects of prolonged blood pressure control after carotid artery stenting
title_full_unstemmed	Beneficial effects of prolonged blood pressure control after carotid artery stenting
title_sort	beneficial effects of prolonged blood pressure control after carotid artery stenting
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/719e172a779347d9bb99ee1ad7b7d6c7
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_version_	1718399344113090560

Beneficial effects of prolonged blood pressure control after carotid artery stenting

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