Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control. The ARIC Study. Atherosclerosis Risk in Communities Study

Stroke; a Journal of Cerebral Circulation
D LiaoH A Tyroler

Abstract

White matter lesions (WML) may result from cerebral hypoperfusion or ischemia. We investigated the association of WML with blood pressure, hypertension, and its treatment and control. A random sample of 1920 participants aged 55 to 72 years in the Atherosclerosis Risk in Communities Study (ARIC) was examined. Spin-density 1.5-T MRI scan images were coded from 0 for normal to 9 for most severe WML. Hypertension was defined as systolic or diastolic pressure > or = 140/90 mm Hg or use of antihypertensive medication. The percentages of persons with WML grades 0 through 2 and 3 through 9, respectively, were as follow: normotensive, 92.4% and 7.6%, versus all hypertensive subjects, 83% and 17% (P < .001); and treated controlled hypertensive, 86% and 14%, versus treated uncontrolled hypertensive subjects, 76% and 24% (P = .003). Multivariable adjusted odds ratios (95% confidence intervals) for WML grade > or = 3 relative to normotensive subjects was 2.34 (1.71 to 3.20) for all hypertensives, 1.99 (1.19 to 3.08) for untreated hypertensives, 1.94 (1.32 to 2.85) for treated controlled hypertensives, and 3.40 (2.30 to 5.03) for treated uncontrolled hypertensives. After additional adjustment for hypertension duration, treatment, and contro...Continue Reading

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