Takashi Hisamatsu1,2, Takayoshi Ohkubo1,3, Atsushi Hozawa1,4, Akira Fujiyoshi1,5, Sayuki Torii1, Hiroyoshi Segawa1,6, Keiko Kondo1,6, Aya Kadota1,6, Naoyuki Takashima1,7, Satoshi Shitara8, Hisatomi Arima1,9, Yoshihisa Nakagawa10,6, Yoshiyuki Watanabe11, Akihiko Shiino12, Kazuhiko Nozaki8,6, Hirotsugu Ueshima1,6, Katsuyuki Miura1,6. 1. Department of Public Health. 2. Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama. 3. Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo. 4. Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai. 5. Department of Hygiene, Wakayama Medical University, Wakayama. 6. NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu. 7. Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama. 8. Department of Neurosurgery. 9. Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. 10. Department of Cardiovascular Medicine. 11. Department of Radiology. 12. Molecular Neuroscience Research Center.
Abstract
OBJECTIVE: Hypertension and intracranial artery stenosis (ICAS) are closely related; however, few studies have compared the strength of the relationship between strictly measured office and out-of-office blood pressure (BP) measurements. The relationship of day-by-day or short-term variability in BP to asymptomatic ICAS also remains unclear. METHODS: In apparently healthy 677 men (mean age, 70 years) from a population-based cohort, we examined the association of strictly measured office BP and 7-day home BP with ICAS on magnetic resonance angiography. We conducted 24-h ambulatory BP monitoring in 468 of the men. Variability indices included day-by-day, daytime, and night-time variability, nocturnal decline, and morning pressor surge. Any ICAS was defined as either mild (1-49%) or severe (≥50%) stenosis. RESULTS: We observed mild and severe ICAS in 153 (22.6%) and 36 (5.3%) participants, respectively. In multivariable-adjusted Poisson regression with robust error variance, higher SBP in office, home, or ambulatory BP monitoring was associated with the presence of any or severe ICAS. The associations with ICAS were comparable between office, home, and ambulatory SBP (all heterogeneity P values >0.1). Independent of mean SBP, greater nocturnal decline or morning pressor surge, but not day-by-day, daytime, or night-time variability, in SBP was associated with higher burden of any or severe ICAS. CONCLUSION: The magnitude of association of strictly measured office BP for asymptomatic ICAS was comparable with that of BP measured at home or in ambulatory BP monitoring. Circadian BP variation based on ambulatory BP monitoring was positively associated with asymptomatic ICAS burden.
OBJECTIVE: Hypertension and intracranial artery stenosis (ICAS) are closely related; however, few studies have compared the strength of the relationship between strictly measured office and out-of-office blood pressure (BP) measurements. The relationship of day-by-day or short-term variability in BP to asymptomatic ICAS also remains unclear. METHODS: In apparently healthy 677 men (mean age, 70 years) from a population-based cohort, we examined the association of strictly measured office BP and 7-day home BP with ICAS on magnetic resonance angiography. We conducted 24-h ambulatory BP monitoring in 468 of the men. Variability indices included day-by-day, daytime, and night-time variability, nocturnal decline, and morning pressor surge. Any ICAS was defined as either mild (1-49%) or severe (≥50%) stenosis. RESULTS: We observed mild and severe ICAS in 153 (22.6%) and 36 (5.3%) participants, respectively. In multivariable-adjusted Poisson regression with robust error variance, higher SBP in office, home, or ambulatory BP monitoring was associated with the presence of any or severe ICAS. The associations with ICAS were comparable between office, home, and ambulatory SBP (all heterogeneity P values >0.1). Independent of mean SBP, greater nocturnal decline or morning pressor surge, but not day-by-day, daytime, or night-time variability, in SBP was associated with higher burden of any or severe ICAS. CONCLUSION: The magnitude of association of strictly measured office BP for asymptomatic ICAS was comparable with that of BP measured at home or in ambulatory BP monitoring. Circadian BP variation based on ambulatory BP monitoring was positively associated with asymptomatic ICAS burden.
Authors: Eeva P Juhanoja; Teemu J Niiranen; Jouni K Johansson; Pauli J Puukka; Lutgarde Thijs; Kei Asayama; Ville L Langén; Atsushi Hozawa; Lucas S Aparicio; Takayoshi Ohkubo; Ichiro Tsuji; Yutaka Imai; George S Stergiou; Antti M Jula; Jan A Staessen Journal: Hypertension Date: 2017-02-13 Impact factor: 10.190
Authors: G Mancia; A Zanchetti; E Agabiti-Rosei; G Benemio; R De Cesaris; R Fogari; A Pessina; C Porcellati; A Rappelli; A Salvetti; B Trimarco; E Agebiti-Rosei; A Pessino Journal: Circulation Date: 1997-03-18 Impact factor: 29.690
Authors: Katherine T Mills; Joshua D Bundy; Tanika N Kelly; Jennifer E Reed; Patricia M Kearney; Kristi Reynolds; Jing Chen; Jiang He Journal: Circulation Date: 2016-08-09 Impact factor: 29.690
Authors: Peter M Rothwell; Sally C Howard; Eamon Dolan; Eoin O'Brien; Joanna E Dobson; Bjorn Dahlöf; Peter S Sever; Neil R Poulter Journal: Lancet Date: 2010-03-13 Impact factor: 79.321