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Associations between systemic blood pressure parameters and intraplaque hemorrhage in symptomatic intracranial atherosclerosis: a high-resolution MRI-based study

Hypertension Research volume 43, pages 688–695 (2020)Cite this article

Abstract

The associations between blood pressure parameters and intracranial vulnerable plaques have not been fully elucidated. The purpose of this study was to investigate the associations between systemic blood pressure parameters, as well as their variability, and intraplaque hemorrhage (IPH) in stroke patients with intracranial atherosclerosis. We retrospectively analyzed the high-resolution MRI data set of intracranial atherosclerosis from a comprehensive stroke center. The atherosclerotic plaque burden and presence of IPH in each vessel were obtained from vessel wall imaging. Blood pressure parameters in the first week of admission were used. The systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and their variability (standard deviation [SD] and coefficient of variation [CV]) were compared between the IPH (+) and IPH (−) groups. Logistic regression analysis was used to demonstrate the correlations between different blood pressure parameters and IPH. The results indicated that SBP and PP were associated with multiple plaques and severe luminal stenosis after adjusting for confounders, with OR = 1.071, 95% CI: (1.044–1.098) and OR = 1.039, 95% CI: (1.019–1.060) for SBP and OR = 1.058, 95% CI: (1.027–1.089) and OR = 1.044, 95% CI: (1.019–1.070) for PP, respectively. SBP was associated with IPH after adjusting for cardiovascular risk factors, with OR = 1.021, 95% CI: (1.003–1.038), but not after correcting for plaque burden, with OR = 1.014, 95% CI: (0.996–1.032). No associations between blood pressure variability and atherosclerotic plaque burden or IPH were detected in this study. In conclusion, SBP is associated with IPH after adjusting for cardiovascular risk factors but not after further correction for atherosclerotic plaque burden. The association between blood pressure variability and intracranial atherosclerosis requires further study.

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Acknowledgements

This study is supported by the Beijing Municipal Science & Technology Commission (Z171100001017019), Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20152201), Tsinghua University Initiative Scientific Research Program (20161080076), and Beijing Municipal Health Bureau project (2013-2-034).

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Authors and Affiliations

  1. Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

    Xiaowei Song, Wendeng Xu, Jun Zhang, Chenming Wei & Jian Wu

  2. Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

    Xihai Zhao, Yilan Xu, Lixue Wang & Zhuozhao Zheng

  3. Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

    Xihai Zhao

  4. Neurovascular Imaging Research Core and Stroke Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA

    David S. Liebeskind

  5. Tsinghua University Hospital, Beijing, China

    Jian Wu

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  1. Xiaowei Song
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Song, X., Zhao, X., Liebeskind, D.S. et al. Associations between systemic blood pressure parameters and intraplaque hemorrhage in symptomatic intracranial atherosclerosis: a high-resolution MRI-based study. Hypertens Res 43, 688–695 (2020). https://doi.org/10.1038/s41440-020-0411-7

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