Association between within-visit blood pressure variability, stroke, coronary heart disease, and cardiovascular mortality

Anisetti, Bhrugun; Youssef, Hossam; Elkhair, Ahamed M.; Lin, Michelle P.

doi:10.5603/pjnns.94839

Cited by 2 publications

(1 citation statement)

References 34 publications

(36 reference statements)

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“…We did not find a statistically significant association with IS and its subtypes for cholesterol or triglycerides. Previous studies have also shown that vascular risk factors differ between the aetiological subtypes of ischaemic stroke [37][38][39][40]. This is probably explained by the heterogeneity of the causes of IS.…”

Section: Discussionmentioning

confidence: 96%

Lipoprotein (a) concentration as a risk factor for ischaemic stroke and its subtypes

Lackova,

Gdovinova,

Kozarova

et al. 2024

Neurol Neurochir Pol.

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Aim of the study. To investigate the relationship between serum lipoprotein (a) [Lp(a)] concentration and the risk of ischaemic stroke (IS) and its subtypes.Clinical rationale for the study. Lp(a) plays a role in atherogenic, pro-thrombotic, and antifibrinolytic processes. Elevated plasma Lp(a) is a strong independent risk factor for the development and progression of atherosclerotic disease. The association between lipoproteins and IS is more complex than that reported for cardiovascular diseases, with inconsistent and contradictory results from epidemiological studies.Material and methods. 231 patients with acute IS (defined as cases) and 163 age-and sex-matched control subjects were included in this prospective case-control study. Demographic and clinical variables (i.e. age, sex, smoking, presence of chronic diseases and concomitant medication) and laboratory data (i.e. concentrations of total cholesterol, high-density lipoprotein--cholesterol, low-density lipoprotein-cholesterol, triglycerides, Lp(a), apolipoprotein A1, apolipoprotein B) were recorded.Results. The mean age and the percentage of men did not significantly differ between groups. Compared to controls, there was a significantly higher percentage of cases reported with concomitant diseases: diabetes mellitus, myocardial infarction, ischaemic heart disease, peripheral arterial disease, and atrial fibrillation. The study showed a significantly higher serum Lp(a) concentration in cases than in control subjects (81.81 nmol/L [c.32.7 mg/dL] vs. 59.75 nmol/L [c.23.9 mg/dL]; p = 0.036) and found an association between Lp(a) levels stratified by quartiles and the risk for ischaemic stroke (Q1 [Lp(a) < 13 nmol/L] vs. Q4 [Lp(a) > 117 nmol/L]: OR 2.23; 95% CI 1.23-4.03; p = 0.008). A subgroup analysis based on the TOAST classification of IS also showed a significant association between Lp(a) value of more than 75 nmol/L (30 mg/dL) and the risk of large-artery atherosclerosis stroke compared to the controls (OR 2.4; 95% CI 1.39-3.93; p = 0.001), as well as a statistically non-significant association with other subtypes of IS. The influence of Lp(a) remained significant even after adjusting for established risk factors for IS (OR 1.99; 95% CI 1.05-3.76; p = 0.04; respectively for the large-artery atherosclerotic subtype: OR 2.54; 95% CI 1.39-4.67; p = 0.003). Conclusion.We found that Lp(a) is an independent risk factor for ischaemic stroke, and for the large-artery atherosclerotic subtype of ischaemic stroke.

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Section: Discussionmentioning

confidence: 96%

Lipoprotein (a) concentration as a risk factor for ischaemic stroke and its subtypes

Lackova,

Gdovinova,

Kozarova

et al. 2024

Neurol Neurochir Pol.

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Metabolic syndrome parameters' variability and stroke incidence in hypertensive patients: evidence from a functional community cohort

Liu,

Wu,

Shao

et al. 2024

Cardiovasc Diabetol

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Background Stroke is a common complication of hypertension, but the predictive value of metabolic syndrome parameters' variability on stroke risk in individuals with hypertension remains unclear. Therefore, our objective was to investigate the relationship between metabolic syndrome parameters' variability and the risk of total stroke and its subtypes in hypertensive patients. Methods This prospective cohort study included 17,789 individuals with hypertension from the Kailuan study since 2006. Metabolic syndrome parameters, including waist circumference (WC), fasting blood glucose (FBG), systolic blood pressure (SBP), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG), were collected at three follow-up visits in the 2006, 2008, and 2010 surveys. We assess the variability utilizing the coefficient of variation (CV), standard deviation (SD), average real variation (ARV), and variability independent of the mean (VIM), with CV initially assessed. Participants were categorized based on the number of high-variability metabolic syndrome parameters (0, 1, 2, ≥ 3). Stroke cases were identified by reviewing medical records. The associations between variability in metabolic syndrome parameters and the risk of total stroke and its subtypes were analyzed using Cox proportional hazard regression models. Results During a median follow-up of 9.32 years, 1223 cases of stroke were recorded. Participants with ≥ 3 high-variability metabolic syndrome parameters had an increased risk of total stroke (HR: 1.29, 95%CI 1.09–1.52), as well as an increased risk of ischemic stroke (HR: 1.31, 95%CI 1.05–1.63) compared to those without high-variability parameters. The study also examined variability in each metabolic syndrome parameter, and significant associations with an increased risk of total stroke were observed for variability in SBP (HR: 1.24, 95%CI 1.05–1.46) and HDL-C (HR: 1.34, 95%CI 1.09–1.64). Conclusions Long-term fluctuations in metabolic syndrome parameters significantly increase the risk of total stroke, especially ischemic stroke. Maintaining low variability in metabolic syndrome parameters could benefit health, and hypertensive individuals must be regularly monitored.

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Association between within-visit blood pressure variability, stroke, coronary heart disease, and cardiovascular mortality

Cited by 2 publications

References 34 publications

Lipoprotein (a) concentration as a risk factor for ischaemic stroke and its subtypes

Lipoprotein (a) concentration as a risk factor for ischaemic stroke and its subtypes

Metabolic syndrome parameters' variability and stroke incidence in hypertensive patients: evidence from a functional community cohort

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