Twenty-four-hour ambulatory blood-pressure variability is associated with total magnetic resonance-imaging burden in cerebral small-vessel disease

Abstract

BackgroundLacunae, brain atrophy, white matter hyperintensity, enlarged perivascular space and microbleed are magnetic resonance imaging (MRI) markers of cerebral small-vessel disease (cSVD). Studies have reported that higher blood pressure variability (BPV) predicted cardiovascular risk in hypertensive patients; however, the association between BPV and the total MRI burden of cSVD has not been investigated. In this study, we aimed to explore this relationship between BPV and cSVD MRI burden.MethodsWe prospectively recruited patients who attended our hospital for annual physical examination. Twenty-four-hour ambulatory BP monitoring was performed using an automated system. BPV was quantified by SD, weighted SD, and coefficient of variation. One point was awarded for the presence of each marker, producing a score between 0 and 5. Spearman correlation and ordinal logistic regression analyses were used to test the relationship between BPV and total cSVD MRI burden.ResultsA total of 251 subjects with an average age of 68 years were enrolled in this study, and 52.6% were male; 163 (64.94%) had one or more markers of cSVD. Correlation analysis indicated that higher systolic BP (SBP) levels and BPV metrics of SBP were positively related to higher cSVD burden. Ordinal logistic regression analyses demonstrated that higher SBP levels and SBP variability were independent risk factors for cSVD. There were no significant differences in 24-hour, day and night diastolic BP levels or BPV metrics of diastolic BP among the five subgroups.ConclusionTwenty-four-hour, day and night SBP levels and SBP variability were positively related to cSVD burden. Higher SBP levels and SBP variability were independent risk factors for cSVD.

Day-to-Day Home Blood Pressure Variability is Associated with Cerebral Small Vessel Disease Burden in a Memory Clinic Population

“…Previous studies have mainly focused on the association between individual markers of cSVD and mainly measured BPV within other timeframes, i.e., from visit-to-visit or within 24-h. For example, several studies reported an association between WMH severity or progression and visit-to-visit BPV in healthy older adults [21,39]. Only Yang et al 2018have reported the total cSVD score in relation to BPV [26]. These authors found that higher 24-h BPV was associated with cSVD burden in a healthy sample with a mean age of 68 years.…”

An IL-18-centered inflammatory network as a biomarker for cerebral white matter injury

“…cSVD has been associated with global cognitive decline, decreased executive function and reduced processing speeds [2][3][4]. Individuals with poorer cardiovascular health have higher cross-sectional cSVD burden and accelerated disease progression [5,6]. Early detection of those at risk for cSVD would allow patients to improve their vascular health and possibly slow the progression of cSVD and cognitive decline associated with poor vascular health [7,8].…”

Ambulatory Blood Pressure Levels in the Prediction of Progression of Cerebral Small Vessel Disease

“…8,9 Several studies have described associations between ABPM levels and individual MRI markers of cSVD 8,[10][11][12] and total cSVD burden. 13,14 However, most results have come from cross-sectional studies. [11][12][13][14][15][16] Given that cSVD progression is prevalent in older adults with hypertension, 3 longitudinal studies assessing the relationship between ABPM levels and cSVD progression may be of interest.…”

“…13,14 However, most results have come from cross-sectional studies. [11][12][13][14][15][16] Given that cSVD progression is prevalent in older adults with hypertension, 3 longitudinal studies assessing the relationship between ABPM levels and cSVD progression may be of interest.…”