FACTORS ASSOCIATED WITH PROGRESSION OF ARTERIAL STIFFNESS IN ISCHEMIC STROKE SURVIVORS: THE NORWEGIAN STROKE IN THE YOUNG STUDY

Abstract

Objective: Progressive arterial stiffening may contribute to risk for recurrent cardiovascular events in ischemic stroke survivors. Few studies have investigated sex differences in prospective change in arterial stiffness in this patient group. Design and method: Arterial stiffness by carotid-femoral pulse wave velocity (PWV) and ambulatory 24-hours blood pressure (BP) were assessed in 81 women and 190 men included in the Norwegian Stroke in the Young (NOR-SYS) study at 3 months and 5.5 years after the incident ischemic stroke. Results: At baseline patients were 49.5 ± 9.9 years old. Women had less prevalent hypertension (48 % vs. 62 %, p<0.05) than men, while age, obesity and smoking prevalence did not differ significantly. During follow-up, BP increased from 129/79 mmHg to 133/83 mmHg in women (p<0.05) and remained statistically unchanged in men (136/83 vs 139/84 mmHg, p = 0.10). Among patients with hypertension, 79% of women were treated at baseline and 77% at follow-up (p = ns), while antihypertensive treatment increased from 82% to 87% in men (p<0.05). Daily smoking was reduced from 47% to 21% in women and from 51% to 21% in men (both p<0.001). Fewer women than men were treated with statins at follow-up (63% vs. 76%, p<0.05). PWV was lower in women than in men both at baseline (7.3 m/s vs. 8.1 m/s) and at follow-up (7.3 m/s vs. 8.0 m/s, both p<0.001), but the average change during follow-up did not differ between genders. In linear regression analysis, increase in PWV was associated with higher 24-hour systolic BP, and lack of antihypertensive treatment at follow-up (both with p<0.05); while no association was found with sex, smoking at follow-up or statin treatment (Table1). Conclusions: In ischemic stroke survivors, 5-year increase in PWV did not differ between the sexes and was associated with higher 24-hour systolic BP and lack of antihypertensive treatment, pointing to the importance of antihypertensive treatment in this patient group.