Aug 29, 2013

Ambulatory blood pressure in patients with lacunar stroke: association with total MRI burden of cerebral small vessel disease

Stroke; a Journal of Cerebral Circulation
Pim KlarenbeekJulie Staals

Abstract

Asymptomatic lacunar infarcts, white matter lesions, cerebral microbleeds, and enlarged perivascular spaces are MRI markers of cerebral small vessel disease (cSVD). Higher blood pressure (BP) levels are associated with the presence of these markers separately, but the association with the total burden of cSVD on brain MRI, expressed by the simultaneous presence of multiple markers of cSVD (a compound score), has not been investigated. We performed 24-hour ambulatory BP monitoring in 122 patients with first-ever lacunar stroke. On brain MRI, we scored the presence of each marker of cSVD. One point was awarded for the presence of each marker, producing a score between 0 and 4. Associations with BP levels were tested with ordinal regression analyses. Eighteen (15%) patients had no markers of cSVD, and 6 (5%) patients had 4 markers. Most patients (45; 37%) had 2 different markers. After correction for age and sex, higher 24-hour, day, and night systolic (24-hour odds ratio, 1.25; 95% confidence interval, 1.02-1.52 per 10 mm Hg) and diastolic (24-hour odds ratio, 1.32; 95% confidence interval, 1.12-1.56 per 5 mm Hg) BP were all significantly associated with an increasing total burden of cSVD. We found a positive association of ambul...Continue Reading

Mentioned in this Paper

Structure of Perivascular Space
Diastolic Blood Pressure
Brain
Odds Ratio
Hypertensive Disease
11-dehydrocorticosterone
Cerebral Hemisphere Structure (Body Structure)
Blood Pressure
Specialty Type - Ambulatory
Cerebral Small Vessel Diseases

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