Association between Twenty-Four-Hour Ambulatory Blood Pressure Variability and Cerebral Small Vessel Disease Burden in Acute Ischemic Stroke

Abstract

Objective. This study is aimed at investigating the association between the twenty-four-hour ambulatory blood pressure variability monitoring (ABPM) and cerebral small vessel disease (cSVD) burden in acute ischemic stroke (AIS) patients. Methods. 115 AIS patients with demographics, vascular risk factors, 24 h ABPM, and brain magnetic resonance imaging (MRI) were retrospectively enrolled. 3.0 T MRI was used to assess cSVD burden by combining four MRI markers including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), perivascular spaces (PVS), and lacunes. Correlation analysis was conducted to detect whether ABPM was associated with cSVD burden in AIS patients. Results. 115 AIS patients with mean age 68.77 ± 10.26 years and 75.7% male were enrolled in this study. 112 AIS patients (97.4%) had at least one cSVD marker. Spearman correlation analysis indicated that hypertension was positively correlated with cSVD burden ( ρ = 0.21 , P = 0.07 ). High-density lipoprotein (HDL) was negatively correlated with cSVD burden ( ρ = − 0.21 , P = 0.02 ). Blood pressure variability such as 24 h mean SBP ( ρ = 0.23 , P = 0.01 ), day mean SBP ( ρ = 0.23 , P = 0.01 ), and night mean SBP ( ρ = 0.20 , P = 0.04 ) was positively correlated with higher cSVD burden. Ordinal logistic regression analysis demonstrated that higher 24 h SBP SD and day mean SBP were independent risk factors for cSVD after controlling for other confounders. Conclusions. Higher BPV was significantly related to total cSVD burden in AIS patients. 24 h SBP SD and day mean SBP were independent risk factors for cSVD burden in AIS patients but not DBP or DBP variability.

Impact of blood pressure variability and cerebral small vessel disease: A systematic review and meta-analysis

“…Our analysis included 19 studies [ 15 , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] ] involving 14519 participants. Among them, 10 studies were from China, 2 each from Japan, South Korea,the United States and the Netherlands, and one from Spain; A total of 6668 male patients, 7851 female patients.…”

“…The AHRQ was used to score the 13 cross-sectional research papers. The results showed that scores of 9, 8, 7, and 6 were obtained by three [ 23 , 24 , 38 ], two [ 31 , 35 ], four [ 29 , 32 , 36 , 39 ], and four papers [ 15 , 25 , 30 , 33 ], respectively.…”

Leukoaraiosis: Epidemiology, Imaging, Risk Factors, and Management of Age-Related Cerebral White Matter Hyperintensities

“…[130][131][132] Moreover, a growing number of studies have found that BPV is linked to CSVD-related phenomena such as LA, cerebral microbleeds, and lacunes. [133][134][135][136][137][138][139][140][141][142][143] Most of these studies showed that increased SBP variability was related to a higher risk or burden of LA, 133,135,136,138,141,143 although a few studies did not find any significant associations. [144][145][146] A recent meta-analysis of populationbased prospective cohort studies also found a significant and positive association between SBP variability and LA.…”