Hypertension, especially poorly controlled, tied to increased aneurysm wall enhancement on MRI

Hypertension, especially poorly controlled, was linked to higher aneurysm wall enhancement (AWE) on MRI (OR 1.93; poorly controlled OR 2.58 vs normotension) in a matched multicenter analysis of 427 hypertensive and 427 normotensive patients with unruptured intracranial aneurysms.

• After propensity score matching, hypertension was independently associated with higher AWE prevalence (OR 1.93, 95% CI 1.49–2.49) using ordinal regression.
• Poorly controlled hypertension (systolic BP ≥140 or diastolic BP ≥90 mmHg) had a stronger association (OR 2.58, 95% CI 1.77–3.77) than well-controlled hypertension (OR 1.72, 95% CI 1.31–2.28).
• The cross-sectional design cannot establish causality; longitudinal studies are needed to confirm if blood pressure control reduces aneurysm wall inflammation and rupture risk.

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