{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T09:11:35Z","timestamp":1784020295526,"version":"3.55.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,6,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although hypertension is prevalent in adults with moyamoya disease (MMD) and intracranial hemorrhage significantly worsens prognosis, the impact of hypertension on long\u2010term outcomes after encephaloduroarteriosynangiosis in hemorrhagic MMD remains unclear; this retrospective cohort study used propensity score matching to compare outcomes between hypertensive and nonhypertensive patients and preliminarily assess the role of blood pressure management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">After propensity score matching, long\u2010term outcomes post\u2010 encephaloduroarteriosynangiosis in patients with hemorrhagic MMD with hypertension from January 2010 to December 2018 were analyzed. The clinical and radiological data were collected. Kaplan\u2013Meier curves evaluated the relationship between recurrence\u2010free survival, overall survival (OS), and hypertension. Univariate and multivariate Cox regression assessed independent factors influencing hematoma recurrence\u2010free survival and OS. Subgroup analysis of patients with hemorrhagic MMD with hypertension assessed the impact of different blood management on long\u2010term outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Kaplan\u2013Meier curves showed a significant correlation between hypertension and decreased hematoma recurrence\u2010free survival (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.004) and OS (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.014) during follow\u2010up. The 5\u2010year recurrence\u2010free survival rate did not significantly differ between hypertensive and nonhypertensive groups (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.77). Hypertension was associated with reduced 10\u2010year hematoma recurrence\u2010free survival (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.004) and OS (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.014). In multivariate analysis, hypertension (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.015), perioperative complications (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.003), and choroidal anastomosis (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.0008) significantly influenced hematoma recurrence\u2010free survival. Analysis of OS revealed significant differences for hypertension (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.018), follow\u2010up duration (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001), choroidal anastomosis (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.041), and initial mRS (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001). Subgroup analysis showed that optimal blood pressure management significantly reduced hematoma recurrence (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.049) but did not improve OS (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.31).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This study highlights significant differences in hematoma recurrence\u2010free survival and OS between patients with hemorrhagic MMD with and without hypertension. A subgroup analysis of those with hypertension showed that optimal blood pressure control notably lowered hematoma recurrence but did not improve OS. For patients with hemorrhagic MMD with hypertension, optimizing blood pressure alone may be insufficient, emphasizing the importance of personalized integrated strategies for this patient subgroup.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039054","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T06:49:08Z","timestamp":1750056548000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Long\u2010Term Outcomes in Patients With Hemorrhagic Moyamoya Disease Combined With Hypertension After Encephaloduroarteriosynangiosis"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6538-375X","authenticated-orcid":false,"given":"Qingbao","family":"Guo","sequence":"first","affiliation":[{"name":"XI\u2019AN NO.9 HOSPITAL","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1372-8135","authenticated-orcid":false,"given":"Manli","family":"Xie","sequence":"additional","affiliation":[{"name":"Xi\u2019an Central Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Ji","sequence":"additional","affiliation":[{"name":"The Eighth Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6389-2347","authenticated-orcid":false,"given":"Qian\u2010Nan","family":"Wang","sequence":"additional","affiliation":[{"name":"The Eighth Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1204-7386","authenticated-orcid":false,"given":"Xiangyang","family":"Bao","sequence":"additional","affiliation":[{"name":"The Fifth Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7210-056X","authenticated-orcid":false,"given":"Lian","family":"Duan","sequence":"additional","affiliation":[{"name":"The First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.8.1274"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000115643"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1969.00480090076012"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(97)00053-X"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.130666"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007010050313"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.3.0468"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(97)00033-4"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.004994"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/2017.12.JNS172246"},{"key":"e_1_3_2_12_2","first-page":"44","article-title":"Hypertension. 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