BACKGROUND AND PURPOSE: The fluctuation of circadian blood pressure (BP) is of great diversity in patients with essential hypertension and may provide significant prognostic value for stroke. However, it remains uncertain whether reverse-dipper pattern of BP influences the incidence of lacunar infarction in hypertensive patients. METHODS: In the current study, 362 hypertensive patients (195 males, 167 females) were enrolled. BP patterns were evaluated with 24-h ambulatory BP monitoring (ABPM). Multinomial logistic regression was applied to analyse the possible relationships between lacunar infarction and various clinical risk factors such as ABPM. RESULTS: A total of 93 patients (25.7%) had reverse-dipper BP pattern. Non-dipper pattern of BP was observed in 179 hypertensive patients (49.4%) and dipper pattern in 90 patients (24.9%). The percentage of lacunar infarction was the highest in the patients with reverse-dipper pattern compared with pure hypertension or atherothrombotic cerebral infarction (P < 0.05). After multinomial logistic regression analysis, reverse-dipper pattern of BP (odds ratio 2.492; 95% confidence interval 1.133-5.479; P < 0.05) and age (odds ratio 1.084; 95% confidence interval 1.047-1.123; P < 0.01) were found to be directly associated with lacunar infarction. CONCLUSIONS: Reverse-dipper BP pattern may serve as an independent risk factor for lacunar infarction and more personalized BP management should be offered to the patients who have elevated nocturnal BP.
BACKGROUND AND PURPOSE: The fluctuation of circadian blood pressure (BP) is of great diversity in patients with essential hypertension and may provide significant prognostic value for stroke. However, it remains uncertain whether reverse-dipper pattern of BP influences the incidence of lacunar infarction in hypertensivepatients. METHODS: In the current study, 362 hypertensivepatients (195 males, 167 females) were enrolled. BP patterns were evaluated with 24-h ambulatory BP monitoring (ABPM). Multinomial logistic regression was applied to analyse the possible relationships between lacunar infarction and various clinical risk factors such as ABPM. RESULTS: A total of 93 patients (25.7%) had reverse-dipper BP pattern. Non-dipper pattern of BP was observed in 179 hypertensivepatients (49.4%) and dipper pattern in 90 patients (24.9%). The percentage of lacunar infarction was the highest in the patients with reverse-dipper pattern compared with pure hypertension or atherothrombotic cerebral infarction (P < 0.05). After multinomial logistic regression analysis, reverse-dipper pattern of BP (odds ratio 2.492; 95% confidence interval 1.133-5.479; P < 0.05) and age (odds ratio 1.084; 95% confidence interval 1.047-1.123; P < 0.01) were found to be directly associated with lacunar infarction. CONCLUSIONS: Reverse-dipper BP pattern may serve as an independent risk factor for lacunar infarction and more personalized BP management should be offered to the patients who have elevated nocturnal BP.
Authors: Anthony G Chesebro; Jesus D Melgarejo; Reinier Leendertz; Kay C Igwe; Patrick J Lao; Krystal K Laing; Batool Rizvi; Mariana Budge; Irene B Meier; Gustavo Calmon; Joseph H Lee; Gladys E Maestre; Adam M Brickman Journal: Neurology Date: 2020-04-15 Impact factor: 9.910
Authors: Lu Sun; Bin Yan; Ya Gao; Dan Su; Liyuan Peng; Yang Jiao; Yuhuan Wang; Donggang Han; Gang Wang Journal: Sci Rep Date: 2016-04-25 Impact factor: 4.379
Authors: Bin Yan; Liyuan Peng; Donggang Han; Lu Sun; Quan Dong; Pengtao Yang; Fengwei Zheng; HeanYee Ong; Lingfang Zeng; Gang Wang Journal: Medicine (Baltimore) Date: 2015-03 Impact factor: 1.889