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

¹ Clinica Neurologica, Università degli Studi di Brescia, P. le Spedali Civili, 1, 25100 Brescia, Italia
² Stroke Unit, Dipartimento di Neuroscienze, Università di Perugia, Via E. dal Pozzo, 06123 Perugia, Italia
³ Istituto di Neurologia, Dipartimento di Neuroscienze, Università di Parma, Strada del Quartiere 4, 43100 Parma, Italia
⁴ Dipartimento di Scienze Sanitarie Applicate, Sezione di Statistica Medica ed Epidemiologia, Università degli Studi di Pavia, Pavia, Italia

Correspondence to:
Correspondence to:
Dr A Pezzini
Clinica Neurologica, Università degli Studi di Brescia, P. le Spedali Civili, 1, 25100 Brescia, Italia; ale_pezzini{at}hotmail.com

ABSTRACT
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.

Abbreviations: CAD, cervical artery dissection; CI, confidence interval; ICAD, internal carotid artery dissection; OR, odds ratio; s, spontaneous; VAD, vertebral artery dissection

Keywords: arterial hypertension; cerebral ischaemia; cervical artery dissection

This article has been cited by other articles:

				T. Brandt and S. R. Levine Spontaneous cervical artery dissection: Is there a gender innuendo? Neurology, September 26, 2006; 67(6): 932 - 933. [Full Text] [PDF]

				M. Arnold, L. Kappeler, D. Georgiadis, K. Berthet, B. Keserue, M. G. Bousser, and R. W. Baumgartner Gender differences in spontaneous cervical artery dissection. Neurology, September 26, 2006; 67(6): 1050 - 1052. [Abstract] [Full Text] [PDF]