Beneficial effects of prolonged blood pressure control after carotid artery stenting

Anna Chang, Huei Fong Hung, Fang-I Hsieh, Wei-Hung Chen, Hsu Ling Yeh, Jiann Horng Yeh, Hou Chang Chiu, Li-Ming Lien

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)103-109
Number of pages7
JournalClinical Interventions in Aging
Volume12
DOIs
Publication statusPublished - Jan 6 2017

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Carotid Arteries
Blood Pressure
Carotid Stenosis
Linear Models
Hypotension
Antihypertensive Agents

Keywords

  • Antihypertensive agents
  • Baroreflex
  • Carotid artery stenosis
  • Cerebral autoregulation
  • Hemodynamics
  • Post-stenting hypotension

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Beneficial effects of prolonged blood pressure control after carotid artery stenting. / Chang, Anna; Hung, Huei Fong; Hsieh, Fang-I; Chen, Wei-Hung; Yeh, Hsu Ling; Yeh, Jiann Horng; Chiu, Hou Chang; Lien, Li-Ming.

In: Clinical Interventions in Aging, Vol. 12, 06.01.2017, p. 103-109.

Research output: Contribution to journalArticle

Chang, Anna ; Hung, Huei Fong ; Hsieh, Fang-I ; Chen, Wei-Hung ; Yeh, Hsu Ling ; Yeh, Jiann Horng ; Chiu, Hou Chang ; Lien, Li-Ming. / Beneficial effects of prolonged blood pressure control after carotid artery stenting. In: Clinical Interventions in Aging. 2017 ; Vol. 12. pp. 103-109.
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abstract = "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 = "Antihypertensive agents, Baroreflex, Carotid artery stenosis, Cerebral autoregulation, Hemodynamics, Post-stenting hypotension",
author = "Anna Chang and Hung, {Huei Fong} and Fang-I Hsieh and Wei-Hung Chen and Yeh, {Hsu Ling} and Yeh, {Jiann Horng} and Chiu, {Hou Chang} and Li-Ming Lien",
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AU - Chang, Anna

AU - Hung, Huei Fong

AU - Hsieh, Fang-I

AU - Chen, Wei-Hung

AU - Yeh, Hsu Ling

AU - Yeh, Jiann Horng

AU - Chiu, Hou Chang

AU - Lien, Li-Ming

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AB - 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.

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KW - Baroreflex

KW - Carotid artery stenosis

KW - Cerebral autoregulation

KW - Hemodynamics

KW - Post-stenting hypotension

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