Evaluation of vertebrobasilar artery changes in patients with benign paroxysmal positional vertigo

Zhang, Daopei; Zhang, Shuling; Zhang, Hongtao; Xu, Yuming; Fu, Shengqi; Yu, Meng; Peng, Ji

doi:10.1097/wnr.0b013e328364b948

Cited by 14 publications

(13 citation statements)

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“…In patients with an intima–media thickness greater than 1.1 mm, the level of residual senses of positional vertigo was higher (Wada et al, 2009). A study by Zhang et al (2013) also revealed increased abnormalities in the vertebrobasilar arteries of BPPV patients. The severity of vertigo was correlated with vertebral artery stenosis, occlusion, or tortuosity (Zhang et al, 2013).…”

Section: Discussionmentioning

confidence: 87%

“…A study by Zhang et al (2013) also revealed increased abnormalities in the vertebrobasilar arteries of BPPV patients. The severity of vertigo was correlated with vertebral artery stenosis, occlusion, or tortuosity (Zhang et al, 2013). These reports are in accordance with our findings (Table 1), which showed that patients with BPPV had a higher prevalence of hypertension and coronary artery disease.…”

Section: Discussionmentioning

confidence: 87%

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Increased Risk of Ischemic Stroke in Patients with Benign Paroxysmal Positional Vertigo: A 9-Year Follow-Up Nationwide Population Study in Taiwan

Kao

Cheng

Leu

et al. 2014

Front. Aging Neurosci.

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Benign paroxysmal positional vertigo (BPPV) is a common form of vertigo and is characterized by episodic dizziness related to changes in head position relative to gravity. BPPV symptoms can be similar to those of central nervous system vascular diseases. The association between BPPV and ischemic stroke has not yet been investigated. The study cohort consisted of patients who were diagnosed with BPPV at least twice in the previous year as an outpatient or for whom BPPV was the primary diagnosis as an inpatient (n = 4104). An age- and gender-matched sample that excluded patients with a diagnosis of any form of vertigo was selected as the comparison cohort (n = 8397). All cases were followed up from January 1, 2000, to December 31, 2008. The demographic characteristics, medical comorbidities, and use of medications in both groups were investigated using chi-square tests. A stratified analysis of stroke risk factors was performed to determine the hazard ratios of BPPV. During the 9-year follow-up period, 185 of the 4104 (4.5%) subjects with BPPV and 240 of the 8379 (2.9%) subjects without BPPV developed ischemic strokes. The crude hazard ratio of BPPV for developing ischemic strokes was 1.708. After adjusting for stroke risk factors, the risk of developing ischemic strokes in BPPV subjects was 1.415-fold higher than the risk among those without BPPV (confidence interval: 1.162–1.732, p = 0.001). After a subgroup analysis stratified according to stroke risk factors, BPPV remained independently associated with a higher risk of developing future ischemic stroke. We conclude that BPPV is independently associated with a risk of subsequent ischemic stroke. More aggressive control of modifiable risk factors for ischemic strokes should be conducted in patients with BPPV.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

Increased Risk of Ischemic Stroke in Patients with Benign Paroxysmal Positional Vertigo: A 9-Year Follow-Up Nationwide Population Study in Taiwan

Kao

Cheng

Leu

et al. 2014

Front. Aging Neurosci.

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“…Some studies have investigated associations between vascular risk factors and BPPV, such as hypertension, DM, and hyperlipidemia, but the results were controversial (4,19). In addition, vascular comorbidities may also be risk factors for BPPV recurrence (8,9).…”

Section: Discussionmentioning

confidence: 99%

“…However, the underlying causes of BPPV remain unclear. In recent decades, many studies have investigated risk factors for the occurrence of BPPV, including female gender, serum vitamin D deficiency, osteoporosis, vascular risk factors, head trauma, and other potential risk factors (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). However, there are some controversies among these studies.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

et al. 2020

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Background and Purpose: The lifetime prevalence of benign paroxysmal positional vertigo (BPPV) is high, especially in the elderly. Patients with BPPV are more susceptible to ischemic stroke, dementia, and fractures, severely reducing quality of life of patients. Many studies have analyzed risk factors for the occurrence of BPPV. However, the results of these studies are not identical. We performed this meta-analysis to determine potential risk factors associated with the occurrence of BPPV. Methods: PubMed, EMBASE, and the Cochrane Library (January 2000 through March 2020) were systematically searched for eligible studies analyzing risk factors for the occurrence of BPPV. Reference lists of eligible studies were also reviewed. We selected observational studies in English with a control group and sufficient data. Pooled odds ratios (ORs) or the mean differences (MDs) and 95% confidence intervals (CIs) were calculated to measure the impacts of all potential risk factors. Heterogeneity among studies was evaluated using the Q-test and I 2 statistics. We used the randomeffect model or the fixed-effect model according to the heterogeneity among the included studies. Results: We eventually included 19 studies published between 2006 and 2019, including 2,618 patients with BPPV and 11,668 participants without BPPV in total. In this meta-analysis, the occurrence of BPPV was significantly associated with female gender (OR = 1.18; 95% CI, 1.05-1.32; P = 0.004), serum vitamin D level (MD = −2.12; 95% CI, −3.85 to −0.38; P = 0.02), osteoporosis (OR = 2.49; 95% CI, 1.39-4.46; P = 0.002), migraine (OR = 4.40; 95% CI, 2.67-7.25; P < 0.00001), head trauma (OR = 3.42; 95% CI, 1.21-9.70; P = 0.02), and total cholesterol level (MD = 0.32; 95% CI, 0.02-0.62; P = 0.03). Conclusion: Female gender, vitamin D deficiency, osteoporosis, migraine, head trauma, and high TC level were risk factors for the occurrence of BPPV. However, the effects of other risk factors on BPPV occurrence need further investigations.

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“…Besides microvascular damage, macrovascular damage is seen in people with diabetes and hypertension. Arteriosclerotic changes were seen in the carotid arteries of 71% of people with BPPV compared to 43% of people with other vestibular disorders [34], while stenosis or occlusion of the vertebrobasilar artery was seen in 21% of people with BPPV, compared to 6.8% of people without BPPV [42]. Elderly people (mean age 57.36±15.44 years) with BPPV and comorbidities like hypertension and diabetes have a higher risk of ischemic stroke (4.5% compared to 2.9% without BPPV) [17].…”

Section: Discussionmentioning

confidence: 99%

Retrospective data suggests that the higher prevalence of benign paroxysmal positional vertigo in individuals with type 2 diabetes is mediated by hypertension

D’Silva

Staecker

Lin

et al. 2016

VES

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Objective Benign Paroxysmal Positional Vertigo (BPPV) has been linked to comorbidities like diabetes and hypertension. However, the relationship between type 2 diabetes (DM) and BPPV is unclear. The purpose of this retrospective study was to examine the relationship between DM and BPPV in the presence of known contributors like age, gender and hypertension. Methods A retrospective review of the records of 3933 individuals was categorized by the specific vestibular diagnosis and for the presence of type 2 DM and hypertension. As the prevalence of BPPV was higher in people with type 2 DM compared to those without DM, multivariable logistic regressions were used to identify variables predictive of BPPV. The relationship between type 2 DM, hypertension and BPPV was analyzed using mediation analysis. Results BPPV was seen in 46% of individuals with type 2 DM, compared to 37% of individuals without DM (p<0.001). Forty two percent of the association between type 2 DM and BPPV was mediated by hypertension, and supported hypertension as a complete mediator in the relationship between type 2 DM and BPPV. Conclusions Hypertension may provide the mediating pathway by which diabetes affects the vestibular system. Individuals with complaints of dizziness, with comorbidities including hypertension and diabetes, may benefit from a screening for BPPV.

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Evaluation of vertebrobasilar artery changes in patients with benign paroxysmal positional vertigo

Cited by 14 publications

References 18 publications

Increased Risk of Ischemic Stroke in Patients with Benign Paroxysmal Positional Vertigo: A 9-Year Follow-Up Nationwide Population Study in Taiwan

Increased Risk of Ischemic Stroke in Patients with Benign Paroxysmal Positional Vertigo: A 9-Year Follow-Up Nationwide Population Study in Taiwan

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

Retrospective data suggests that the higher prevalence of benign paroxysmal positional vertigo in individuals with type 2 diabetes is mediated by hypertension

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