机构：[1]Department of Radiology University of Pennsylvania Philadelphia PA.[2]Department of Radiology University of Southern California Los Angeles CA.[3]Department of Radiology Chaoyang Hospital Beijing China.北京朝阳医院[4]Department of Radiology Xuanwu Hospital Beijing China.医技科室放射科首都医科大学宣武医院[5]Department of Neurology Cedars-Sinai Medical Center Los Angeles CA.[6]Biomedical Imaging Research Institute Cedars-Sinai Medical Center Los Angeles CA.[7]Department of Biomedical Engineering University of Southern California Los Angeles CA.
Background Studies suggest the presence of sex differences in hypertension prevalence and its associated outcomes in atherosclerosis and stroke. We hypothesized a higher intracranial atherosclerosis burden among men with hypertension and acute ischemic stroke compared with women. Methods and Results A multicenter retrospective study was performed from a prospective database identifying patients with hypertension presenting with intracranial atherosclerosis-related acute ischemic stroke and imaged with intracranial vessel wall magnetic resonance imaging. Proximal and distal plaques on vessel wall magnetic resonance imaging were scored. Negative binomial models assessed the associations between plaque-count and sex and the interaction between sex and treatment. Covariates were selected by a least absolute shrinkage and selection operator procedure. Sixty-one patients (n=42 men) were included. There were no significant differences in demographic or cardiovascular risk factors except for smoking history (P=0.002). Adjusted total and proximal plaque counts for men were 1.6 (95% CI, 1.2-2.1; P<0.01) and 1.4 (95% CI, 1.0-1.9; P=0.03) times as high as women, respectively. Female sex was more protective for proximal plaque if treated for hypertension. The risk ratio of men versus women was 1.5 (95% CI, 1.0-2.1) for treated patients. The risk ratio of men versus women was 0.7 (95% CI, 0.4-1.3) for untreated patients. The relative difference between these 2 risk ratios was 2.0 (95% CI, 1.1-3.9), which was statistically significant from the interaction test, P=0.04. Conclusions Men with hypertension with acute ischemic stroke have significantly higher total and proximal plaque burdens than women. Women with hypertension on anti-hypertensive medication showed a greater reduction in proximal plaque burden than men. Further confirmation with a longitudinal cohort study is needed and may help evaluate whether different treatment guidelines for managing hypertension by sex can help reduce intracranial atherosclerosis burden and ultimately acute ischemic stroke risk.
基金：
This study is supported by the NHLBI (R01 HL147355) (Fan) and NINDS (L30
NS118632) (J.W. Song).
第一作者机构：[1]Department of Radiology University of Pennsylvania Philadelphia PA.
共同第一作者：
通讯作者：
通讯机构：[2]Department of Radiology University of Southern California Los Angeles CA.[6]Biomedical Imaging Research Institute Cedars-Sinai Medical Center Los Angeles CA.[7]Department of Biomedical Engineering University of Southern California Los Angeles CA.[*1]Keck School of Medicine, Viterbi School of Engineering, University of Southern California, 2250 Alcazar St, CSC Room 104, Los Angeles, CA 90033
推荐引用方式(GB/T 7714)：
Song Jae W,Xiao Jiayu,Cen Steven Y,et al.Sex Differences in Intracranial Atherosclerosis in Patients With Hypertension With Acute Ischemic Stroke.[J].JOURNAL OF THE AMERICAN HEART ASSOCIATION.2022,11(10):doi:10.1161/JAHA.122.025579.
APA：
Song Jae W,Xiao Jiayu,Cen Steven Y,Liu Xiao,Wu Fang...&Fan Zhaoyang.(2022).Sex Differences in Intracranial Atherosclerosis in Patients With Hypertension With Acute Ischemic Stroke..JOURNAL OF THE AMERICAN HEART ASSOCIATION,11,(10)
MLA：
Song Jae W,et al."Sex Differences in Intracranial Atherosclerosis in Patients With Hypertension With Acute Ischemic Stroke.".JOURNAL OF THE AMERICAN HEART ASSOCIATION 11..10(2022)
医学