Abstract
Hypertension with high homocysteine (HHcy) (H-type hypertension) and C reactive protein (CRP) can increase the incidence of ischemic stroke. However, it is not clear whether recurrent ischemic stroke (RIS) is related to H-type hypertension and CRP. The present study investigated the correlation of H-type hypertension and CRP level with RIS. Totally, 987 consecutive patients with acute ischemic stroke were recruited in a teaching hospital in Henan province, China during March 2014 to March 2015. The demographic and clinical characteristics and blood biochemical parameters of patients were analyzed. Elevated levels of CRP and homocysteine (Hcy) were defined as >8.2 mg/L and 10 μmol/L, respectively. Among the 987 patients, 234 were RIS. Thirty-eight percent of RIS patients had elevated CRP level and 91.5% of RIS patients had HHcy. In multivariate analysis, adjusted odds ratio (OR) of RIS in patients aged ≥60 years was 1.576 (95% CI: 1.125–2.207), in male patients 1.935 (95% CI: 1.385–2.704), in patients with diabetes 1.463 (95% CI: 1.037–2.064), CRP levels 1.013 (95% CI: 1.006–1.019), simple hypertension 3.370 (95% CI: 1.15–10.183), and H-type hypertension 2.990 (95% CI: 1.176–7.600). RIS was associated with older age, male, diabetes, H-type hypertension and CRP. Controlling H-type hypertension and CRP level may reduce the risk of RIS.
Highlights
Cerebrovascular disease has become the leading cause of death in China, having about 60%–80%attribution by ischemic stroke [1], which is one of the main causes of death in many countries.With the improvement of medicine, the mortality rate of stroke has declined, but the recurrence rate is increasing in recent years
There was no significant difference between recurrent ischemic stroke (RIS) and first-ever ischemic stroke (FIS) in marital status, smoking, alcohol drinking, family history, coronary heart disease, glucose (GLU), uric acid (UA), fibrinogen (FIB), white blood cells (WBC), red blood cells (RBC), platelets (PLT) and Hcy level (p > 0.05)
The present results indicated that the level of C reactive protein (CRP) in RIS was significantly higher than that in FIS and that the CRP level was an independent risk factor for RIS after adjusting for covariates (OR = 1.012, 95% CI: 1.006–1.018), which is similar with previous study suggesting that hsCRP predicts the risk of RIS among patients with recent lacunar stroke [35]
Summary
Cerebrovascular disease has become the leading cause of death in China, having about 60%–80%attribution by ischemic stroke [1], which is one of the main causes of death in many countries.With the improvement of medicine, the mortality rate of stroke has declined, but the recurrence rate is increasing in recent years. Cerebrovascular disease has become the leading cause of death in China, having about 60%–80%. Attribution by ischemic stroke [1], which is one of the main causes of death in many countries. With the improvement of medicine, the mortality rate of stroke has declined, but the recurrence rate is increasing in recent years. Previous research showed that the risk of recurrent ischemic stroke (RIS). Reaches up to 9% after six months, with cumulative rate about 4% after one year and 10-year recurrence rate of 43% [2]. RIS demonstrates higher mortality and disability rate than the first-ever ischemic stroke (FIS), and it causes more economic pressure and manpower burden to families and society. Res. Public Health 2016, 13, 477; doi:10.3390/ijerph13050477 www.mdpi.com/journal/ijerph
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