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Three-year follow-up of blood pressure after treating hypertensive patients with symptomatic carotid artery stenosis

  • Original Article - Vascular
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Abstract

Background

Blood pressure (BP) was reported to decrease significantly after carotid endarterectomy (CEA) or carotid stenting (CAS) up to the 1-year follow-up. We evaluated changes in BP for 3 years after treating hypertensive patients with symptomatic carotid artery stenosis by either CEA or CAS and determined predisposing factors for normotensive BP at the 3-year follow-up.

Methods

A total of 123 hypertensive patients with at least 3 years of clinical and radiographic follow-up after treatment were included in this study and placed in the CEA (n = 65) or CAS group (n = 58). BP changes for 3 years, the number of patients with a normotensive BP (≤120/80 mmHg), and the percentage decrease in BP were evaluated and compared between groups.

Results

Compared to pretreatment BP, the CEA group had significantly decreased BP at the 1- and 2-year follow-up (p < 0.05), but not the 3-year follow-up. The CAS group had significantly decreased BP at the 1-, 2-, and 3-year follow-up (p < 0.05). Stenosis location (body lesions over apical lesions; OR = 1.526, 95 % CI, 1.341 to 6.224; p = 0.034) was an independent predisposing factor for normotensive BP at the 3-year follow-up.

Conclusions

For hypertensive patients with symptomatic carotid artery stenosis, BP was lowered at 3 years after both CEA and CAS compared to pretreatment BP. CAS might lower BP better over the long term than did CEA, and hypertensive patients with stenosis at body lesions might be normotensive at 3 years after CEA or CAS.

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Authors and Affiliations

  1. Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Chang-Ki Hong & Joonho Chung

  2. Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 135-720, Republic of Korea

    Chang-Ki Hong & Joonho Chung

  3. Department of Neurosurgery, Inha University School of Medicine, Incheon, Republic of Korea

    Yu Shik Shim & Hyeonseon Park

  4. Department of Neurosurgery, Ajou University School of Medicine, Suwon, Republic of Korea

    Yong Cheol Lim

  5. Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Yong Sam Shin

  6. Department of Neurological Surgery, Rush University Medical Center, 1725 W. Harrison Street, Suite 855, Chicago, IL, 60612, USA

    Joonho Chung

Authors
  1. Chang-Ki Hong
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  2. Yu Shik Shim
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  3. Yong Cheol Lim
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  4. Yong Sam Shin
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  5. Hyeonseon Park
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  6. Joonho Chung
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Corresponding author

Correspondence to Joonho Chung.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patient-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of retrospective study formal consent is not required.

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Hong, CK., Shim, Y.S., Lim, Y.C. et al. Three-year follow-up of blood pressure after treating hypertensive patients with symptomatic carotid artery stenosis. Acta Neurochir 158, 2385–2392 (2016). https://doi.org/10.1007/s00701-016-2990-2

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  • DOI: https://doi.org/10.1007/s00701-016-2990-2

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