Arterial pre‐hypertension and hypertension in intracranial versus extracranial cerebrovascular stenosis

Background and purpose Since it has remained unclear whether arterial pre‐hypertension is a risk factor for cerebrovascular diseases, potential associations between arterial pre‐hypertension and intracranial arterial stenosis ( ICAS ) and extracranial arterial stenosis ( ECAS ) were assessed. Methods The population‐based Asymptomatic Polyvascular Abnormalities in Community Study was a sub‐study of employees and retirees of the coal mining industry in China. Our study examined asymptomatic polyvascular abnormalities in a general population and with an age of 40+ years without history of stroke, transient ischaemic attacks and coronary heart disease. ICAS was diagnosed by transcranial Doppler sonography and was defined by peak flow velocity criteria; ECAS was diagnosed by carotid duplex sonography and was defined by the diameter of the common carotid artery or internal carotid artery. Results Out of 4422 study participants, 711 (16.1%) subjects showed an asymptomatic ICAS and 292 (6.6%) showed an asymptomatic ECAS . After adjusting for relevant risk factors, higher prevalence of ICAS was significantly associated with higher prevalence of pre‐hypertension [odds ratio ( OR ) 1.55; 95% confidence interval ( CI ) 1.11, 2.16; P  = 0.010] and hypertension ( OR  1.80; 95% CI 1.53, 2.11; P  < 0.001). Stratified by gender, the association was stronger for men than for women. Asymptomatic ECAS was not significantly associated with the prevalence of pre‐hypertension ( OR  0.78; 95% CI  0.55, 1.10) or of hypertension ( OR  1.06; 95% CI  0.91, 1.24). Conclusions The results suggest that arterial pre‐hypertension in addition to hypertension is associated with a higher prevalence of asymptomatic ICAS , more in men.