Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke

A Community-Based Study

Shao Yuan Chuang, Hao Min Cheng, Chyi Huey Bai, Wen Ting Yeh, Jiunn Rong Chen, Wen Harn Pan

Research output: Contribution to journalArticle

Abstract

Background and Purpose - High blood pressure is a major cause of cardiovascular events, and carotid flow pulsatility may be associated with cardiovascular events. However, the combined effect of blood pressure and flow pulsatility on the development of stroke remains unclear. Therefore, we investigated the combined influence of central blood pressure and pulsatility index (PI) on the incidence of stroke. Methods - Baseline data from 2033 adults (≥30 years) without stroke history in the Cardiovascular Disease Risk Factor Two-Township Study were linked to incident stroke. Common carotid flow PI was calculated by peak systolic velocity, end-diastolic velocity, and mean vessel velocity, which were measured in the common carotid artery. Hazard ratios for the risk of total stroke resulting from high central systolic blood pressure (CSBP) and high PI were calculated with Cox proportional hazard models. Results - Over a median follow-up of 9.81 years, 132 people incurred stroke events. The incidence rates of stroke were 1.3, 6.4, and 13.2 per 1000 person-years for tertile groups of CSBP (P for trend<0.05) and 4.3, 7.0, and 9.4 per 1000 person-years for tertile groups of PI (P for trend<0.05). Compared with the first tertile of CSBP, hazard ratios were 4.88 (95% confidence interval, 2.29-10.43) for the second tertile and 10.42 (5.05-21.53) for the third tertile. Hazard ratios of PI were 2.18 (1.39-3.42; third tertile) and 1.64 (1.02-2.63; second tertile) compared with the first tertile. The individuals with a high CSBP and high PI had a 13-fold higher stroke risk compared with those with low CSBP and low PI (13.2; 1.75-99.71) after adjusting for age, sex, and traditional cardiovascular risk. Conclusions - CSBP and common carotid PI jointly and independently predicted future stroke. Carotid flow pulsatility may play an important role in the development of stroke.

Original languageEnglish
Pages (from-to)2262-2268
Number of pages7
JournalStroke
Volume47
Issue number9
DOIs
Publication statusPublished - Sep 1 2016

Fingerprint

Stroke
Blood Pressure
Common Carotid Artery
Incidence
Proportional Hazards Models
Cardiovascular Diseases
Odds Ratio
Confidence Intervals
Hypertension

Keywords

  • adult
  • blood pressure
  • prospective studies
  • risk factors
  • stroke

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke : A Community-Based Study. / Chuang, Shao Yuan; Cheng, Hao Min; Bai, Chyi Huey; Yeh, Wen Ting; Chen, Jiunn Rong; Pan, Wen Harn.

In: Stroke, Vol. 47, No. 9, 01.09.2016, p. 2262-2268.

Research output: Contribution to journalArticle

Chuang, Shao Yuan ; Cheng, Hao Min ; Bai, Chyi Huey ; Yeh, Wen Ting ; Chen, Jiunn Rong ; Pan, Wen Harn. / Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke : A Community-Based Study. In: Stroke. 2016 ; Vol. 47, No. 9. pp. 2262-2268.
@article{5050b584d07943a481d9beff120df0ca,
title = "Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke: A Community-Based Study",
abstract = "Background and Purpose - High blood pressure is a major cause of cardiovascular events, and carotid flow pulsatility may be associated with cardiovascular events. However, the combined effect of blood pressure and flow pulsatility on the development of stroke remains unclear. Therefore, we investigated the combined influence of central blood pressure and pulsatility index (PI) on the incidence of stroke. Methods - Baseline data from 2033 adults (≥30 years) without stroke history in the Cardiovascular Disease Risk Factor Two-Township Study were linked to incident stroke. Common carotid flow PI was calculated by peak systolic velocity, end-diastolic velocity, and mean vessel velocity, which were measured in the common carotid artery. Hazard ratios for the risk of total stroke resulting from high central systolic blood pressure (CSBP) and high PI were calculated with Cox proportional hazard models. Results - Over a median follow-up of 9.81 years, 132 people incurred stroke events. The incidence rates of stroke were 1.3, 6.4, and 13.2 per 1000 person-years for tertile groups of CSBP (P for trend<0.05) and 4.3, 7.0, and 9.4 per 1000 person-years for tertile groups of PI (P for trend<0.05). Compared with the first tertile of CSBP, hazard ratios were 4.88 (95{\%} confidence interval, 2.29-10.43) for the second tertile and 10.42 (5.05-21.53) for the third tertile. Hazard ratios of PI were 2.18 (1.39-3.42; third tertile) and 1.64 (1.02-2.63; second tertile) compared with the first tertile. The individuals with a high CSBP and high PI had a 13-fold higher stroke risk compared with those with low CSBP and low PI (13.2; 1.75-99.71) after adjusting for age, sex, and traditional cardiovascular risk. Conclusions - CSBP and common carotid PI jointly and independently predicted future stroke. Carotid flow pulsatility may play an important role in the development of stroke.",
keywords = "adult, blood pressure, prospective studies, risk factors, stroke",
author = "Chuang, {Shao Yuan} and Cheng, {Hao Min} and Bai, {Chyi Huey} and Yeh, {Wen Ting} and Chen, {Jiunn Rong} and Pan, {Wen Harn}",
year = "2016",
month = "9",
day = "1",
doi = "10.1161/STROKEAHA.116.013207",
language = "English",
volume = "47",
pages = "2262--2268",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke

T2 - A Community-Based Study

AU - Chuang, Shao Yuan

AU - Cheng, Hao Min

AU - Bai, Chyi Huey

AU - Yeh, Wen Ting

AU - Chen, Jiunn Rong

AU - Pan, Wen Harn

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background and Purpose - High blood pressure is a major cause of cardiovascular events, and carotid flow pulsatility may be associated with cardiovascular events. However, the combined effect of blood pressure and flow pulsatility on the development of stroke remains unclear. Therefore, we investigated the combined influence of central blood pressure and pulsatility index (PI) on the incidence of stroke. Methods - Baseline data from 2033 adults (≥30 years) without stroke history in the Cardiovascular Disease Risk Factor Two-Township Study were linked to incident stroke. Common carotid flow PI was calculated by peak systolic velocity, end-diastolic velocity, and mean vessel velocity, which were measured in the common carotid artery. Hazard ratios for the risk of total stroke resulting from high central systolic blood pressure (CSBP) and high PI were calculated with Cox proportional hazard models. Results - Over a median follow-up of 9.81 years, 132 people incurred stroke events. The incidence rates of stroke were 1.3, 6.4, and 13.2 per 1000 person-years for tertile groups of CSBP (P for trend<0.05) and 4.3, 7.0, and 9.4 per 1000 person-years for tertile groups of PI (P for trend<0.05). Compared with the first tertile of CSBP, hazard ratios were 4.88 (95% confidence interval, 2.29-10.43) for the second tertile and 10.42 (5.05-21.53) for the third tertile. Hazard ratios of PI were 2.18 (1.39-3.42; third tertile) and 1.64 (1.02-2.63; second tertile) compared with the first tertile. The individuals with a high CSBP and high PI had a 13-fold higher stroke risk compared with those with low CSBP and low PI (13.2; 1.75-99.71) after adjusting for age, sex, and traditional cardiovascular risk. Conclusions - CSBP and common carotid PI jointly and independently predicted future stroke. Carotid flow pulsatility may play an important role in the development of stroke.

AB - Background and Purpose - High blood pressure is a major cause of cardiovascular events, and carotid flow pulsatility may be associated with cardiovascular events. However, the combined effect of blood pressure and flow pulsatility on the development of stroke remains unclear. Therefore, we investigated the combined influence of central blood pressure and pulsatility index (PI) on the incidence of stroke. Methods - Baseline data from 2033 adults (≥30 years) without stroke history in the Cardiovascular Disease Risk Factor Two-Township Study were linked to incident stroke. Common carotid flow PI was calculated by peak systolic velocity, end-diastolic velocity, and mean vessel velocity, which were measured in the common carotid artery. Hazard ratios for the risk of total stroke resulting from high central systolic blood pressure (CSBP) and high PI were calculated with Cox proportional hazard models. Results - Over a median follow-up of 9.81 years, 132 people incurred stroke events. The incidence rates of stroke were 1.3, 6.4, and 13.2 per 1000 person-years for tertile groups of CSBP (P for trend<0.05) and 4.3, 7.0, and 9.4 per 1000 person-years for tertile groups of PI (P for trend<0.05). Compared with the first tertile of CSBP, hazard ratios were 4.88 (95% confidence interval, 2.29-10.43) for the second tertile and 10.42 (5.05-21.53) for the third tertile. Hazard ratios of PI were 2.18 (1.39-3.42; third tertile) and 1.64 (1.02-2.63; second tertile) compared with the first tertile. The individuals with a high CSBP and high PI had a 13-fold higher stroke risk compared with those with low CSBP and low PI (13.2; 1.75-99.71) after adjusting for age, sex, and traditional cardiovascular risk. Conclusions - CSBP and common carotid PI jointly and independently predicted future stroke. Carotid flow pulsatility may play an important role in the development of stroke.

KW - adult

KW - blood pressure

KW - prospective studies

KW - risk factors

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=84982840881&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84982840881&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.116.013207

DO - 10.1161/STROKEAHA.116.013207

M3 - Article

VL - 47

SP - 2262

EP - 2268

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 9

ER -