Arterial hypertension as risk factor for spontaneous cervical artery dissection. A case–control study

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 77; no. 1; pp. 95 - 97
• Main Authors: Pezzini, A, Caso, V, Zanferrari, C, Del Zotto, E, Paciaroni, M, Bertolino, C, Grassi, M, Agnelli, G, Padovani, A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.01.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Age; arterial hypertension; Atherosclerosis; Biological and medical sciences; CAD; Case-Control Studies; cerebral ischaemia; cervical artery dissection; confidence interval; Diabetes; Dissection; Female; Humans; Hypertension; Hypertension - complications; Hypertension - epidemiology; ICAD; internal carotid artery dissection; Ischemia; Logistic Models; Magnetic resonance imaging; Male; Medical imaging; Medical sciences; Middle Aged; Neurology; odds ratio; Orthopedic surgery; Prospective Studies; Regression analysis; Risk factors; Short Report; spontaneous; Stroke; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; VAD; Vascular diseases and vascular malformations of the nervous system; Veins & arteries; vertebral artery dissection; Vertebral Artery Dissection - epidemiology; Vertebral Artery Dissection - etiology; Arterial disease; Vascular disease; Dissecting aneurysm; Hypertension; Nervous system diseases; Risk factor; Cardiovascular disease; Case control study; Artery dissection
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2005.063107

Because of the presumed non-atherosclerotic pathogenesis, the potential link between spontaneous cervical artery dissection (sCAD) and common risk factors for atherosclerosis has never been investigated systematically. Therefore, this prospective, multicentre, case–control study compared the frequency of tobacco use, hypertension, diabetes mellitus, and hypercholesterolaemia among a group of consecutive patients with sCAD (n  =  153), a group of patients with ischaemic stroke, not related to CAD (non-CAD), and a group of controls. As opposed to the other variables, a trend towards a significant association was seen when the prevalence of hypertension was compared among patients with sCAD and controls (26.8% v 17.0%; odds ratio (OR) 1.79; 95% confidence interval (CI), 0.98 to 3.27; p  =  0.058). Hypertension was also significantly associated with the subgroup of patients with sCAD and cerebral infarction (OR, 1.94; 95% CI, 1.01 to 3.70; p  =  0.045), particularly when involving the vertebral arteries (OR, 2.69; 95% CI, 1.20 to 6.04; p  =  0.017). These findings might help define the spectrum of pathogenic conditions predisposing to sCAD and provide information to help investigate the combined effect of such susceptibility factors in future studies.