Blood pressure-lowering effect of carotid artery stenting in patients with symptomatic carotid artery stenosis.

Abstract

BACKGROUND: In patients with symptomatic carotid artery stenosis, long-term

effects of carotid artery stenting (CAS) on blood pressure (BP) changes have not

been documented well. We evaluated the effects of CAS on BP and found out its

predisposing factors in patients with symptomatic carotid artery stenosis.

METHODS: Between January 2003 and June 2012, a total of 107 patients were

recruited, and all subjects met the following inclusion criteria: (1) patients

underwent CAS with symptomatic carotid artery stenosis > 50%; (2) patients had

clinical and radiographic data for at least 1 year of follow-up after CAS; and

(3) patients had BP measurements at four different time points: pretreatment,

post-treatment, 1-month follow-up, and 1-year follow-up. We evaluated the

significance of the BP changes between the pretreatment BP and follow-up BPs, and

determined its predisposing factors. RESULTS: Compared to the mean

systolic/diastolic BP value (141.0/87.4 mmHg) at the pretreatment BP, the

follow-up BPs were significantly decreased after CAS (120.5/74.5, 126.2/76.9, and

129.2/79.0 mmHg at the post-treatment, the 1-month follow-up, and the 1-year

follow-up, respectively [p < 0.01]). The location of the stenosis (odds ratio =

1.856, 95% confidence interval, 1.388 to 5.589; p = 0.003) and hypertension (odds

ratio = 1.627, 95% confidence interval, 1.101 to 3.757; p = 0.014) were

independent predisposing factors for BP-lowering effects of CAS on multivariate

analysis. CONCLUSIONS: For patients with symptomatic carotid artery stenosis, CAS

might have a BP-lowering effect at the 1-year follow-up, especially in patients

with hypertension or the stenosis at body lesions.