关键词: 经颅多普勒超声, 无症状性颅内动脉狭窄, 高血压, 24小时动态血压

Abstract: Objectives: To investigate the prevalence and determinants of asymptomatic intracranial artery stenosis in untreated patients from hypertension outpatient clinic. Methods: Outpatients having not treated with antihypertensive medi-cation for Ambulatory Blood Pressure Monitoring at Department of Hypertension, Ruijin Hospital from the year of 2009 to 2013 were recruited. Transcranial Doppler ultrasonography was used to assess the stenosis at the bilateral anterior, middle and posterior cerebral arteries and vertebral arteries. T test and Chi square test were used to compare the difference in clinical features between patients with stenosis and those without. Multiple logistic regression analysis was used to analyze the determinants of intracranial arterial stenosis. Results: A total of 1 130 patients with average age of 51 years were enrolled, including 49% males, 63% hypertensives and 5.3% diabetic patients. The prevalence of intracranial arterial stenosis was 7.4% (84 cases). The stenosis located mainly at anterior (45 cases) and middle (44 cases) cerebral arteries, less frequently at posterior (16 cases) or vertebral (7 cases) arteries. No differences in clinic characteristics were found between patients with and without stenosis, except that 24-h systolic blood pressure was significantly higher in patients with intracranial arterial stenosis (132 vs 126 mmHg, P<0.001). Multivariate logistic regression analyses showed that women had higher risk of intracranial arterial stenosis than men by 72% (95% CI, 6%-179%, P=0.026). For every 10 mmHg increase in 24-h systolic blood pressure, the risk of intracranial artery stenosis increased by 56% (29%-88%, P<0.001). Irrespective of the time of measuring (daytime, nighttime, morning), increase of systolic blood pressure was associated with increased risk of intracranial arterial stenosis, and for every 10 mmHg increase, risk of intracranial artery stenosis increased by 34%-47% (P all <0.001). Conclusions: Asymptomatic intracranial artery stenosis is moderately prevalent in untreated Chinese patients at the hypertension clinic, of which systolic blood pressure is an important determinant.

Key words: Transcranial Doppler ultrasonography, Asymptomatic intracranial artery stenosis, Hypertension, 24-h ambulatory blood pressure