Long-term changes in carotid intima-media thickness according to baseline blood pressure level: J-STARS Echo study.

Abstract

We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients. Patients aged 45-80years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140mmHg and diastolic BP [dBP] <90mmHg), highly elevated BP (G2 group: sBP ≥160mmHg or dBP ≥100mmHg), and mildly elevated BP (G1 group: the remaining patients). Mixed effect models were used to examine differences in slope of mean carotid IMT increases annually over the 5-year observation period among three groups, and for two groups divided based on whether they were above or below certain BP cut-off levels set at every 1mmHg, ranging between 139 and 161mmHg for sBP, and 89-101mmHg for dBP. Of 792 patients, baseline mean carotid IMT in the G1-group (0.908±0.152mm) and G2-group (0.905±0.145mm) was significantly higher than the N-group (0.870±0.153mm) (P<0.01, for both respectively). Although there was no significant difference in the increase among three groups (P=0.091), the increase in patients above sBP 154, 159 and 160mmHg or dBP 101mmHg at baseline was higher than others (P<0.05 for all). High baseline BP correlated with a high baseline carotid IMT and its subsequent 5-year increase in non-cardioembolic stroke patients. http://www. gov. NCT00361530.