[Correlation of H-type hypertension and prognosis of ischemic stroke].

ABSTRACT

OBJECTIVE: To examine the correlation between hypertension with hyperhomocysteinemia and prognosis of ischemic stroke. METHODS: A total of 634 patients with acute ischemic stroke confirmed by computed tomography or magnetic resonance imaging were recruited at Department of Neurology, First Affiliated Hospital, Zhengzhou University from January 1, 2007 to May 30, 2010. Their NIHSS (National Institute of Health Stroke Scale) scores were evaluated on admission. And their baseline profiles and probable prognostic factors were recorded. Recovery was assessed by modified Rankin score (MRS) during a 6-month follow-up. Multivariate Logistic regression was performed for statistical analysis. RESULTS: Among them, 32 became lost to follow-up. There were 197 females (32.7%) and 405 males (67.3%) with an average age of (59 ± 13) years (range 19 - 92). The average level of homocysteine was (19 ± 11) µmol/L. There were 343 (57%) patients with hypertension and MRS ≥ 3 was in 145 (31%) patients. Logistic regression analysis showed that significant correlations existed between H-type hypertension and 6-month MRS (P = 0.012, OR = 2.566, 95%CI 1.299 - 5.357) when homocysteine ≥ 15 µmol/L was defined for hyperhomocysteinemia. And there was a total sum of interaction between hypertension and hyperhomocysteinemia. The parameters of relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S) were 0.683, 26.61% and 1.59 respectively. Other parameters with significant prognostic correlations included age, history of stroke, NIHSS score on admission and diastolic blood pressure on admission. CONCLUSION: At the homocysteine level of ≥ 15 µmol/L, H-type hypertension and 6-month MRS have significant correlations. And H-type hypertension is a risk factor for the prognosis of ischemic stroke. When hypertension and hyperhomocysteinemia coexist, there is a total sum of interaction.