Hua Zhang1, Yi Cui2, Yingxin Zhao1, Yuanli Dong3, Juan Wang4, Dandan Duan1, Tiantian Ji1,5, Tingting Zhou1,5, Wenjing Hu1,5, Yali Chen1,5, Shangwen Sun1, Gary Gong6, Qiang Chai1, Zhendong Liu1. 1. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, China. 2. Department of Radiology, Qilu Hospital of Shandong University, China. 3. Department of Community, Lanshan District People Hospital, Shandong, China. 4. Department of Cardiology, The Second Hospital of Shandong University, China. 5. School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, China. 6. The Russel H. Morgan Department of Radiology and Radiological Sciences, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
Abstract
BACKGROUND: Although it is accepted that the etiology of cerebral small vessel disease (CSVD) is associated with cardiovascular risk factors, the association between CSVD and the circadian rhythm of blood pressure (BP) is unclear. We aimed to determine if such an association existed in the elderly population. METHOD: White matter hyperintensities (WMHs), lacunes, microbleeds, nocturnal dipping pattern (NDP), and morning surge in systolic blood pressure (SBP) were assessed in 2,091 participants ≥60 years of age. RESULTS: During an average of 63 months of follow-up, WMH and the WMH-to-intracranial volume ratio were significantly increased in extreme dippers, nondippers, and reverse dippers than those in dippers (p < .001). For new-incident Fazekas scale ≥2, the hazard ratios were 1.77 (95% confidence interval [CI], 1.09-2.86) for extreme dippers, 2.20 (95% CI, 1.48-3.28) for nondippers, and 2.43 (95% CI, 1.59-3.70) for reverse dippers compared with dippers, and 1.04 (95% CI, 0.81-1.35) for higher morning surge compared with lower morning surge. Nondippers and reverse dippers were associated with higher risks of new-incident lacunes and microbleeds than dippers (p < .05). Higher morning surge was associated with a higher risk of new-incident microbleeds than lower morning surge (p < .05). CONCLUSION: NDPs in SBP played an important role in CSVD, and the morning surge in SBP was associated with cerebral microbleeds in community-based elderly population beyond the average SBP level.
BACKGROUND: Although it is accepted that the etiology of cerebral small vessel disease (CSVD) is associated with cardiovascular risk factors, the association between CSVD and the circadian rhythm of blood pressure (BP) is unclear. We aimed to determine if such an association existed in the elderly population. METHOD: White matter hyperintensities (WMHs), lacunes, microbleeds, nocturnal dipping pattern (NDP), and morning surge in systolic blood pressure (SBP) were assessed in 2,091 participants ≥60 years of age. RESULTS: During an average of 63 months of follow-up, WMH and the WMH-to-intracranial volume ratio were significantly increased in extreme dippers, nondippers, and reverse dippers than those in dippers (p < .001). For new-incident Fazekas scale ≥2, the hazard ratios were 1.77 (95% confidence interval [CI], 1.09-2.86) for extreme dippers, 2.20 (95% CI, 1.48-3.28) for nondippers, and 2.43 (95% CI, 1.59-3.70) for reverse dippers compared with dippers, and 1.04 (95% CI, 0.81-1.35) for higher morning surge compared with lower morning surge. Nondippers and reverse dippers were associated with higher risks of new-incident lacunes and microbleeds than dippers (p < .05). Higher morning surge was associated with a higher risk of new-incident microbleeds than lower morning surge (p < .05). CONCLUSION:NDPs in SBP played an important role in CSVD, and the morning surge in SBP was associated with cerebral microbleeds in community-based elderly population beyond the average SBP level.
Authors: Yang Gao; Weiping Deng; Jialan Sun; Dongqi Yue; Bei Zhang; Yulan Feng; Jun Han; Fanxia Shen; Jin Hu; Yi Fu Journal: Front Neurol Date: 2022-05-23 Impact factor: 4.086
Authors: Michelle C Johansen; Rebecca F Gottesman; Brian G Kral; Dhananjay Vaidya; Lisa R Yanek; Lewis C Becker; Diane M Becker; Paul Nyquist Journal: Stroke Date: 2021-05-18 Impact factor: 10.170