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The effect of stenting on blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis
Author(s) -
Che Wuqiang,
Dong Hui,
Jiang Xiongjing,
Xiong Hongliang,
Chen Yang,
Zou Yubao,
Xu Bo,
Gao Runlin
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28650
Subject(s) - medicine , blood pressure , vertebral artery , stenosis , subclavian artery , cardiology , prospective cohort study , revascularization , vertebrobasilar insufficiency , surgery , myocardial infarction
Objective This study aimed to evaluate the effect of stenting on blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis. Background Whether posterior circulation revascularization could reduce blood pressure in hypertensive patients with posterior circulation hypoperfusion has not been investigated in humans. Methods A total of 48 patients with essential hypertension (33 males; mean age 63.0 ± 8.7 years) with symptomatic proximal subclavian or vertebral artery stenosis who underwent stenting successfully at the Fuwai Hospital were prospectively enrolled between January 2014 and December 2015. All 48 patients were followed up at 1, 3, and 6 months after the procedure. Blood pressure, use of antihypertensive agents, and complications were investigated. Results Baseline values included office blood pressure of 132/77 ± 10/8 mmHg, mean 24‐hr blood pressure of 127/75 ± 12/9 mmHg, and mean antihypertensive agents used of 1.6 ± 0.8. Stenosis of the subclavian and vertebral arteries decreased from 88.9 ± 9.5% and 85.8 ± 7.4% to 5.5 ± 3.5% and 4.6 ± 3.7%, respectively, immediately after the procedure. Reductions in office blood pressure were − 7/−3 ( SD 3/2), −9/−4 (5/3), and − 10/−5 (7/5) mmHg at 1, 3, and 6 months, respectively. While 24‐hr blood pressures after the procedure reduced by −5/−3 mmHg at 6 months, the total number of antihypertensive agents used at the aforementioned time points was unchanged. Conclusion This first prospective cohort study in humans showed that posterior circulation stenting is apparently effective in reducing blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis.