OBJECTIVE: Twenty-four-hour ambulatory blood pressure (24-hour ABP) values are considered a powerful predictor of stroke. Silent cerebrovascular lesions are associated with an increased risk of stroke. Because fibrinogen is a major determinant of plasma viscosity, an elevated fibrinogen level might also be associated with stroke risk. We evaluated the association of 24-hour ABP and plasma fibrinogen levels with the risk of silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected by MRI. METHODS AND RESULTS: The study cohort comprised 958 individuals from the general population of Ohasama, a rural Japanese community. Multiple logistic regression analysis adjusted for age, sex, smoking and drinking status, use of antihypertensive medication, body mass index, 24-hour ABP, and a history of hypercholesterolemia, diabetes mellitus, and atrial fibrillation demonstrated that each 1-SD increase in fibrinogen level was associated with a significantly increased risk of silent cerebrovascular lesions (odds ratio, 1.26; P=0.001). The 24-hour ABP was also significantly and independently associated with the risk of silent cerebrovascular lesions. Even when 24-hour ABP values were within normal range (<135/80 mm Hg), elevated fibrinogen levels were associated with an increased risk of silent cerebrovascular lesions. Fibrinogen and 24-hour BP had additive effects on silent cerebrovascular lesions. CONCLUSION: The 24-hour ABP and plasma fibrinogen levels were closely and independently associated with the risk of silent cerebrovascular lesions including white matter hyperintensity and lacunar infarct.
OBJECTIVE: Twenty-four-hour ambulatory blood pressure (24-hour ABP) values are considered a powerful predictor of stroke. Silent cerebrovascular lesions are associated with an increased risk of stroke. Because fibrinogen is a major determinant of plasma viscosity, an elevated fibrinogen level might also be associated with stroke risk. We evaluated the association of 24-hour ABP and plasma fibrinogen levels with the risk of silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected by MRI. METHODS AND RESULTS: The study cohort comprised 958 individuals from the general population of Ohasama, a rural Japanese community. Multiple logistic regression analysis adjusted for age, sex, smoking and drinking status, use of antihypertensive medication, body mass index, 24-hour ABP, and a history of hypercholesterolemia, diabetes mellitus, and atrial fibrillation demonstrated that each 1-SD increase in fibrinogen level was associated with a significantly increased risk of silent cerebrovascular lesions (odds ratio, 1.26; P=0.001). The 24-hour ABP was also significantly and independently associated with the risk of silent cerebrovascular lesions. Even when 24-hour ABP values were within normal range (<135/80 mm Hg), elevated fibrinogen levels were associated with an increased risk of silent cerebrovascular lesions. Fibrinogen and 24-hour BP had additive effects on silent cerebrovascular lesions. CONCLUSION: The 24-hour ABP and plasma fibrinogen levels were closely and independently associated with the risk of silent cerebrovascular lesions including white matter hyperintensity and lacunar infarct.
Authors: Dean Shibata; Astrid Suchy-Dicey; Cara L Carty; Tara Madhyastha; Tauqeer Ali; Lyle Best; Thomas J Grabowski; W T Longstreth; Dedra Buchwald Journal: Neuroepidemiology Date: 2019-06-04 Impact factor: 3.282
Authors: Adam de Havenon; Chelsea Meyer; J Scott McNally; Matthew Alexander; Lee Chung Journal: Curr Atheroscler Rep Date: 2019-07-27 Impact factor: 5.113
Authors: Jonathon P Fanning; Allan J Wesley; David G Platts; Darren L Walters; Eamonn M Eeles; Michael Seco; Oystein Tronstad; Wendy Strugnell; Adrian G Barnett; Andrew J Clarke; Judith Bellapart; Michael P Vallely; Peter J Tesar; John F Fraser Journal: BMC Cardiovasc Disord Date: 2014-04-05 Impact factor: 2.298