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Incidence of Ischemic Stroke in Relation to Asymptomatic Carotid Artery Atherosclerosis in Subjects with Normal Blood Pressure. A Prospective Cohort Study.

Li, Cairu LU ; Engström, Gunnar LU ; Berglund, Göran LU ; Janzon, Lars LU and Hedblad, Bo LU (2008) In Cerebrovascular Diseases 26(3). p.297-303
Abstract
Background:Approximately 10-20% of stroke cases have normal blood pressure (BP). The objective of this study was to explore whether the risk of ischemic stroke is related to the carotid intima-media thickness (CIMT) and atherosclerotic lesions in a cohort of subjects with normal BP. Methods:Common CIMT and the presence of carotid plaque were determined by B-mode ultrasound in 6,103 subjects, randomly recruited between 1991 and 1994 from the 'Malmo Diet and Cancer' study. Normal BP was defined as BP <140/90 mm Hg, without pharmacological treatment for hypertension. Carotid artery atherosclerosis (CAA) was defined as CIMT >/=0.81 mm or/and the presence of plaque (i.e. focal CIMT >1.2 mm). The incidence of ischemic stroke was... (More)
Background:Approximately 10-20% of stroke cases have normal blood pressure (BP). The objective of this study was to explore whether the risk of ischemic stroke is related to the carotid intima-media thickness (CIMT) and atherosclerotic lesions in a cohort of subjects with normal BP. Methods:Common CIMT and the presence of carotid plaque were determined by B-mode ultrasound in 6,103 subjects, randomly recruited between 1991 and 1994 from the 'Malmo Diet and Cancer' study. Normal BP was defined as BP <140/90 mm Hg, without pharmacological treatment for hypertension. Carotid artery atherosclerosis (CAA) was defined as CIMT >/=0.81 mm or/and the presence of plaque (i.e. focal CIMT >1.2 mm). The incidence of ischemic stroke was followed over a mean period of 10.7 years. Results:A total of 2,228 subjects (791 men and 1,437 women) had normal BP. During the follow-up, 34 patients suffered a first-ever ischemic stroke (crude incidence: 1.51/1,000 person-years). The Prevalences of CAA in subjects with and without stroke were 68.6 and 39.0%, respectively. It was estimated that the subjects with CAA had a 3-fold higher risk of ischemic stroke (RR: 3.33, 1.37-8.14), independent of other cardiovascular risk factors. Each increase of 1 standard deviation (0.13 mm) in CIMT increased the stroke risk by 43% (RR: 1.43, 1.002-2.02). Several factors were found to have a notable relation with CAA, including age, male sex, smoking, diabetes, systolic BP, HbA1c (glycosylated hemoglobin) and cholesterol. Conclusions: CIMT and atherosclerotic lesions are independent clinical markers for ischemic stroke among normotensive individuals. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cerebrovascular Diseases
volume
26
issue
3
pages
297 - 303
publisher
Karger
external identifiers
  • pmid:18667810
  • wos:000259725500012
  • scopus:48049097502
ISSN
1421-9786
DOI
10.1159/000149577
language
English
LU publication?
yes
id
2875fe32-f7e0-49d5-8bfc-f2026922cbed (old id 1223659)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18667810?dopt=Abstract
date added to LUP
2008-09-11 13:50:31
date last changed
2017-05-21 03:32:06
@article{2875fe32-f7e0-49d5-8bfc-f2026922cbed,
  abstract     = {Background:Approximately 10-20% of stroke cases have normal blood pressure (BP). The objective of this study was to explore whether the risk of ischemic stroke is related to the carotid intima-media thickness (CIMT) and atherosclerotic lesions in a cohort of subjects with normal BP. Methods:Common CIMT and the presence of carotid plaque were determined by B-mode ultrasound in 6,103 subjects, randomly recruited between 1991 and 1994 from the 'Malmo Diet and Cancer' study. Normal BP was defined as BP &lt;140/90 mm Hg, without pharmacological treatment for hypertension. Carotid artery atherosclerosis (CAA) was defined as CIMT &gt;/=0.81 mm or/and the presence of plaque (i.e. focal CIMT &gt;1.2 mm). The incidence of ischemic stroke was followed over a mean period of 10.7 years. Results:A total of 2,228 subjects (791 men and 1,437 women) had normal BP. During the follow-up, 34 patients suffered a first-ever ischemic stroke (crude incidence: 1.51/1,000 person-years). The Prevalences of CAA in subjects with and without stroke were 68.6 and 39.0%, respectively. It was estimated that the subjects with CAA had a 3-fold higher risk of ischemic stroke (RR: 3.33, 1.37-8.14), independent of other cardiovascular risk factors. Each increase of 1 standard deviation (0.13 mm) in CIMT increased the stroke risk by 43% (RR: 1.43, 1.002-2.02). Several factors were found to have a notable relation with CAA, including age, male sex, smoking, diabetes, systolic BP, HbA1c (glycosylated hemoglobin) and cholesterol. Conclusions: CIMT and atherosclerotic lesions are independent clinical markers for ischemic stroke among normotensive individuals.},
  author       = {Li, Cairu and Engström, Gunnar and Berglund, Göran and Janzon, Lars and Hedblad, Bo},
  issn         = {1421-9786},
  language     = {eng},
  number       = {3},
  pages        = {297--303},
  publisher    = {Karger},
  series       = {Cerebrovascular Diseases},
  title        = {Incidence of Ischemic Stroke in Relation to Asymptomatic Carotid Artery Atherosclerosis in Subjects with Normal Blood Pressure. A Prospective Cohort Study.},
  url          = {http://dx.doi.org/10.1159/000149577},
  volume       = {26},
  year         = {2008},
}