Abstract 13036: Pressure and Pulsatility Jointly Impact the Prognosis of Stroke
Introduction: High blood pressure is major cause of cardiovascular events. Pulsatility of vessel velocity may associate with cardiovascular events. However, the combined effect of blood pressure and pulsatility for stroke remain unclear.
Hypothesis: Therefore, we investigated the joined influence of central blood pressure and pulsatility index for cardiovascular events.
Methods: Baseline data from 2063 adults (30 years or older) in the Cardiovascular Diseases Risk Factor Two-Township Study were linked to incidental total stroke status derived from insurance claims and death certificate records. Hazard ratios for risk of total stroke for high central systolic blood pressure (CSBP) and high plausibility index (PI) was calculated by peak systolic velocity, end diastolic velocity and mean vessel velocity which measured in common carotid artery were calculated using Cox proportional hazard models.
Results: With 9.81 years (median) of follow-up, 139 persons had stroke develop. The incidence rates of stroke were 1.4, 6.5, and 12.1 per 1000 person-years for tertile groups of CSBP (p-value for trend < 0.05) and 4.1, 7.8 and 9.6 per 1000 person-years, respectively for tertile groups of common carotid PI (p-value for trend < 0.05). Compared with the first tertile of CSBP, hazard ratios were 4.70 (95% confidence intervals, 2.17-10.03) for the second tertile and 9.51 (4.59 -19.68) for the third tertile. Hazard ratios of PI were 2.47 (1.52-4.02; third tertile) and 1.81 (95% confidence intervals, 1.09-3.01; second tertile) compared with the first tertile. The individuals with high CSBP and high PI had 13-fold stroke risk compared to those with low CSBP and low PI (13.3; 95% confidence intervals, 1.77-99.9) after adjusting for age, sex, and traditional cardiovascular risk.
Conclusions: Central systolic blood pressure and Common carotid pulsatility index jointly and independently predicted future stroke. Pulsatility of velocity could be one of the etiologies of development of stroke.
Author Disclosures: S. Chuang: None. H. Cheng: None. C. Bai: None. W. Yeh: None. J. Chen: None. W. Pan: None.
- © 2014 by American Heart Association, Inc.