Intracranial Atherosclerosis and Stage 1 Hypertension Defined by the 2017 ACC/AHA Guideline

Ki-Woong Nam, Hyung-Min Kwon, Han-Yeong Jeong, Jin-Ho Park, Hyuktae Kwon, Su-Min Jeong

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new, stricter definition of stage 1 hypertension which was previously considered prehypertension. However, impacts of the novel stage 1 hypertension on deleterious target organ outcomes are still controversial. In this study, we evaluated the relationship between this newly defined stage 1 hypertension and the presence of intracranial atherosclerosis (ICAS) lesions in neurologically healthy participants.

METHODS: We assessed consecutive participants in routine health check-ups between January 2006 and December 2013. BP was classified according to the 2017 ACC/AHA hypertension guideline, and ICAS was defined as occlusion or ≥ 50% stenosis of intracranial vessels on flight magnetic resonance angiography.

RESULTS: Among 3,111 healthy participants (mean age: 56 years, sex: 54% men), 85 (3%) had ICAS lesions. In multivariate analysis, stage 1 hypertension (adjusted odds ratio: 2.46, 95% confidence interval: 1.10-5.51, P = 0.029) remained an independent predictor of ICAS after adjustment for confounders. Stage 2 hypertension showed a higher odds ratio and a lower P-value, indicating a dose-response effect. Age and HbA1c level were also significantly associated with ICAS, independent of the BP categories. The ICAS lesion burden showed a dose-response effect across the BP categories (P for trend < 0.001), while ICAS lesion location did not (P for trend = 0.699).

CONCLUSIONS: We demonstrated that stage 1 hypertension, defined according to the 2017 ACC/AHA guideline, was associated with a higher prevalence and burden of ICAS lesions in a neurologically healthy population.

Original languageEnglish
JournalAmerican Journal of Hypertension
DOIs
StateE-pub ahead of print - 21 Aug 2019

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Intracranial Arteriosclerosis
American Heart Association
Cardiology
Guidelines
Hypertension
Healthy Volunteers
Odds Ratio
Prehypertension
Magnetic Resonance Angiography
Pathologic Constriction
Multivariate Analysis
Confidence Intervals

Cite this

@article{600d0de516a94206a2576f0e95a8b204,
title = "Intracranial Atherosclerosis and Stage 1 Hypertension Defined by the 2017 ACC/AHA Guideline",
abstract = "BACKGROUND: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new, stricter definition of stage 1 hypertension which was previously considered prehypertension. However, impacts of the novel stage 1 hypertension on deleterious target organ outcomes are still controversial. In this study, we evaluated the relationship between this newly defined stage 1 hypertension and the presence of intracranial atherosclerosis (ICAS) lesions in neurologically healthy participants.METHODS: We assessed consecutive participants in routine health check-ups between January 2006 and December 2013. BP was classified according to the 2017 ACC/AHA hypertension guideline, and ICAS was defined as occlusion or ≥ 50{\%} stenosis of intracranial vessels on flight magnetic resonance angiography.RESULTS: Among 3,111 healthy participants (mean age: 56 years, sex: 54{\%} men), 85 (3{\%}) had ICAS lesions. In multivariate analysis, stage 1 hypertension (adjusted odds ratio: 2.46, 95{\%} confidence interval: 1.10-5.51, P = 0.029) remained an independent predictor of ICAS after adjustment for confounders. Stage 2 hypertension showed a higher odds ratio and a lower P-value, indicating a dose-response effect. Age and HbA1c level were also significantly associated with ICAS, independent of the BP categories. The ICAS lesion burden showed a dose-response effect across the BP categories (P for trend < 0.001), while ICAS lesion location did not (P for trend = 0.699).CONCLUSIONS: We demonstrated that stage 1 hypertension, defined according to the 2017 ACC/AHA guideline, was associated with a higher prevalence and burden of ICAS lesions in a neurologically healthy population.",
author = "Ki-Woong Nam and Hyung-Min Kwon and Han-Yeong Jeong and Jin-Ho Park and Hyuktae Kwon and Su-Min Jeong",
note = "{\circledC} American Journal of Hypertension, Ltd 2019. All rights reserved. For Permissions, please email: journals.permissions@oup.com.",
year = "2019",
month = "8",
day = "21",
doi = "10.1093/ajh/hpz138",
language = "English",
journal = "American Journal of Hypertension",
issn = "0895-7061",
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Intracranial Atherosclerosis and Stage 1 Hypertension Defined by the 2017 ACC/AHA Guideline. / Nam, Ki-Woong; Kwon, Hyung-Min; Jeong, Han-Yeong; Park, Jin-Ho; Kwon, Hyuktae; Jeong, Su-Min.

In: American Journal of Hypertension, 21.08.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Intracranial Atherosclerosis and Stage 1 Hypertension Defined by the 2017 ACC/AHA Guideline

AU - Nam, Ki-Woong

AU - Kwon, Hyung-Min

AU - Jeong, Han-Yeong

AU - Park, Jin-Ho

AU - Kwon, Hyuktae

AU - Jeong, Su-Min

N1 - © American Journal of Hypertension, Ltd 2019. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PY - 2019/8/21

Y1 - 2019/8/21

N2 - BACKGROUND: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new, stricter definition of stage 1 hypertension which was previously considered prehypertension. However, impacts of the novel stage 1 hypertension on deleterious target organ outcomes are still controversial. In this study, we evaluated the relationship between this newly defined stage 1 hypertension and the presence of intracranial atherosclerosis (ICAS) lesions in neurologically healthy participants.METHODS: We assessed consecutive participants in routine health check-ups between January 2006 and December 2013. BP was classified according to the 2017 ACC/AHA hypertension guideline, and ICAS was defined as occlusion or ≥ 50% stenosis of intracranial vessels on flight magnetic resonance angiography.RESULTS: Among 3,111 healthy participants (mean age: 56 years, sex: 54% men), 85 (3%) had ICAS lesions. In multivariate analysis, stage 1 hypertension (adjusted odds ratio: 2.46, 95% confidence interval: 1.10-5.51, P = 0.029) remained an independent predictor of ICAS after adjustment for confounders. Stage 2 hypertension showed a higher odds ratio and a lower P-value, indicating a dose-response effect. Age and HbA1c level were also significantly associated with ICAS, independent of the BP categories. The ICAS lesion burden showed a dose-response effect across the BP categories (P for trend < 0.001), while ICAS lesion location did not (P for trend = 0.699).CONCLUSIONS: We demonstrated that stage 1 hypertension, defined according to the 2017 ACC/AHA guideline, was associated with a higher prevalence and burden of ICAS lesions in a neurologically healthy population.

AB - BACKGROUND: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new, stricter definition of stage 1 hypertension which was previously considered prehypertension. However, impacts of the novel stage 1 hypertension on deleterious target organ outcomes are still controversial. In this study, we evaluated the relationship between this newly defined stage 1 hypertension and the presence of intracranial atherosclerosis (ICAS) lesions in neurologically healthy participants.METHODS: We assessed consecutive participants in routine health check-ups between January 2006 and December 2013. BP was classified according to the 2017 ACC/AHA hypertension guideline, and ICAS was defined as occlusion or ≥ 50% stenosis of intracranial vessels on flight magnetic resonance angiography.RESULTS: Among 3,111 healthy participants (mean age: 56 years, sex: 54% men), 85 (3%) had ICAS lesions. In multivariate analysis, stage 1 hypertension (adjusted odds ratio: 2.46, 95% confidence interval: 1.10-5.51, P = 0.029) remained an independent predictor of ICAS after adjustment for confounders. Stage 2 hypertension showed a higher odds ratio and a lower P-value, indicating a dose-response effect. Age and HbA1c level were also significantly associated with ICAS, independent of the BP categories. The ICAS lesion burden showed a dose-response effect across the BP categories (P for trend < 0.001), while ICAS lesion location did not (P for trend = 0.699).CONCLUSIONS: We demonstrated that stage 1 hypertension, defined according to the 2017 ACC/AHA guideline, was associated with a higher prevalence and burden of ICAS lesions in a neurologically healthy population.

U2 - 10.1093/ajh/hpz138

DO - 10.1093/ajh/hpz138

M3 - Article

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

ER -