Correlation between 24-h ambulatory blood pressure variability and the overall burden of cerebral small vessel disease in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4165.2019.08.006
- VernacularTitle:24 h动态血压变异性与急性缺血性卒中患者脑小血管病总体负担的相关性
- Author:
Junfeng QIAN
1
;
Guojun WANG
;
Libiao JI
;
Lei YANG
;
Yanyun LIU
;
Guoxiu KE
Author Information
1. 苏州大学附属常熟医院
- Keywords:
Stroke;
Brain ischemia;
Cerebral small vessel diseases;
Blood pressure;
Blood pressuremonitoring,portable;
Hypertension;
Magnetic resonance imaging;
Risk factors;
Time factor
- From:
International Journal of Cerebrovascular Diseases
2019;27(8):590-596
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation between 24-h ambulatory blood pressure variability and the overall burden of cerebral small vessel disease (CSVD) in patients with acute ischemic stroke. Methods From March 2016 to December 2017, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, the Affiliated Changshu Hospital of Soochow University were enrolled. The 3. 0 T-MRI was used to assess asymptomatic lacunar infarction, white matter hyperintensities, cerebral microbleeds, and enlarged perivascular spaces within 24 h after admission, and the total CSVD score (0-4) was calculated. 24-h ambulatory blood pressure monitoring was performed 24 to 72 h after admission. Ordinal logistic regression analysis was used to determine the independent correlation between the 24-h ambulatory blood pressure-related index and the total CSVD score. Results A total of 220 patients with acute ischemic stroke were enrolled. The patients were divided into five groups according to the total CSVD score. Univariate analysis showed that there were significant differences in age, homocysteine, the proportion of hypertension, as well as 24 h, daytime and nighttime mean systolic blood pressure (SBP), and coefficient of variation of daytime SBP among the 5 groups (all P < 0. 05). Ordinal logistic regression analysis showed that age (odds ratio [OR] 1. 078, 95％ confidence interval [CI] 1. 051-1. 106; P < 0. 001), 24-h mean SBP (OR 1. 043, 95％ CI 1. 026-1. 060; P < 0. 001), daytime mean SBP (OR 1. 042, 95％ CI 1. 025-1. 059; P < 0. 001), nighttime mean SBP (OR 1. 034, 95％ CI 1. 019-1. 049; P < 0. 001), and coefficient of variation of daytime SBP (OR 1. 129, 95％ CI 1. 052-1. 210; P = 0. 003) were independently correlated with the total CSVD score. Conclusions The elevated 24 h, daytime and nighttime mean SBP levels and coefficient of variation of daytime SBP are independently correlated with the severity of overall CSVD burden in patients with acute ischemic stroke.
