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Effect of premorbid hypertension control on outcome of patients with aneurysmal subarachnoid hemorrhage

  • Jianfeng Zheng
  • Rui Xu
  • Guojing Liu
  • Zongduo Guo
  • Xiaochuan Sun
Original Article - Vascular Neurosurgery - Aneurysm
Part of the following topical collections:
  1. Vascular Neurosurgery – Aneurysm

Abstract

Objective

Hypertension is common in patients with aneurysmal subarachnoid hemorrhage (SAH). However, it is still unclear whether premorbid antihypertensive therapy can help to reduce the risk of severe aneurysmal bleeding. Therefore, this study aims to assess the effect of premorbid hypertension control on outcome of patients with aneurysmal SAH.

Methods

We retrospectively reviewed the clinical data of patients with intracranial aneurysms admitted to our institution from February 2012 to December 2017. Based on premorbid hypertension history and use of antihypertensive agents, all patients with aneurysmal SAH were divided into antihypertensive group and uncontrolled group. Patient characteristics, imaging features, clinical complication, and outcome were analyzed between the two groups.

Results

A total of 348 patients with ruptured aneurysms were included in this study. Compared to those with premorbid controlled hypertension, patients with premorbid uncontrolled hypertension presented worse clinical grade, with more severe aneurysmal SAH and more frequent intracerebral hematoma. Patients receiving a treatment for ACEI type or ARB type of drugs in the antihypertensive group suffered from less amount of aneurysmal bleeding, while patients with grade 3 hypertension in the uncontrolled group suffered from more amount of aneurysmal bleeding. Patients with premorbid controlled hypertension had a lower incidence of rebleeding, hydrocephalus, and cerebral vasospasm, and had a lower rate of disability and mortality.

Conclusions

Premorbid hypertension control is associated with favorable clinical outcome of patients with aneurysmal SAH. Besides, the ACEI type or ARB type of antihypertensive agents is associated with the less amount of bleeding after aneurysm rupture.

Keywords

Intracranial aneurysm Subarachnoid hemorrhage Antihypertensive treatment Outcome 

Notes

Funding

National Natural Science Foundation of China (No. 81671160; No. 81571159) and 13th Five-Year National Key Research Project of China (2016YFC1300800; 2016YFC1300804; 2016YFC1300805) provided financial support. The sponsor had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Chongqing Medical University First Affiliated Hospital) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Jianfeng Zheng
    • 1
  • Rui Xu
    • 1
  • Guojing Liu
    • 1
  • Zongduo Guo
    • 1
  • Xiaochuan Sun
    • 1
  1. 1.Department of NeurosurgeryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina

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