The impact of H-type hypertension on intracranial plaque enhancement in patients with ischemic stroke: an HR-MRI study

This study investigates the influence of H-type hypertension on intracranial atherosclerotic plaque enhancement, aiming to improve atherosclerotic plaque risk management and predict outcomes in acute ischemic stroke (AIS) patients.

Involving 148 AIS patients, the study was divided into H-type HTN (70 cases), Iso HTN (27 cases), Iso HHcy (31 cases), and Con groups (20 cases). MRI examinations were conducted within four weeks of symptom onset. Metrics such as stenosis rate, remodeling index, and normalized wall index were assessed, alongside intraplaque hemorrhage detection via HR-MRI. Plaque enhancement was graded (0, 1, 2), and its correlation with H-type hypertension was analyzed using ordinal univariate and multivariate logistic regression.

Grade 2 plaque enhancement appeared more frequently in H-type HTN group (65.2%, P = 0.003). In ordinal univariate regression analysis, hyperhomocysteinemia (OR: 50.350, 95% CI: 2.263–5.575), hypertension (OR: 24.705, 95% CI: 1.559–4.855), H-type hypertension (OR: 79.044, 95% CI: 2.755–5.965) were all associated with plaque enhancement. After adjusting for covariates, H-type hypertension (OR: 24.459, 95% CI: 1.436–4.957) and hyperhomocysteinemia (OR: 16.494, 95% CI: 0.973–4.633) remained independent risk factors for plaque enhancement.

H-type hypertension and hyperhomocysteinemia independently elevate the risk of intracranial atherosclerotic plaque enhancement. Effective management of these conditions is crucial for decreasing plaque instability and AIS incidence.