Blood pressure variability and white matter hyperintensities after ischemic stroke
Background: High blood pressure variability (BPV) may be a risk factor for stroke and dementia in patients with ischemic stroke, but the underlying mechanism is unknown. We aimed to investigate whether high BPV is associated with presence and progression of white matter hyperintensities (WMH). Metho...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Cerebral Circulation - Cognition and Behavior |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666245024000060 |
| _version_ | 1797353640606826496 |
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| author | Nina A Hilkens Frank-Erik de Leeuw Catharina JM Klijn Edo Richard |
| author_facet | Nina A Hilkens Frank-Erik de Leeuw Catharina JM Klijn Edo Richard |
| author_sort | Nina A Hilkens |
| collection | DOAJ |
| description | Background: High blood pressure variability (BPV) may be a risk factor for stroke and dementia in patients with ischemic stroke, but the underlying mechanism is unknown. We aimed to investigate whether high BPV is associated with presence and progression of white matter hyperintensities (WMH). Methods: We performed a post-hoc analysis on the MRI substudy of the PRoFESS trial, including 771 patients with ischemic stroke who underwent MRI at baseline and after a median of 2.1 years. WMH were rated with a semi-quantitative scale. Visit-to-visit BPV was expressed as the coefficient of variation (interval 3–6 months, median number of visits 7). The association of BPV with WMH burden and progression was assessed with linear and logistic regression analyses adjusted for confounders. Results: BPV was associated with burden of periventricular WMH (β 0.36 95%CI 0.19–0.53, per one SD increase in BPV) and subcortical (log-transformed) WMH (β 0.25, 95%CI 0.08–0.42). BPV was not associated with periventricular (OR 1.09, 95%CI 0.94–1.27) and subcortical WMH progression (OR 1.15, 95%CI 0.99–1.35). Associations were independent of mean BP. Conclusion: High visit-to-visit BPV was associated with both subcortical and periventricular WMH burden in patients with ischemic stroke, but not with WMH progression in this study. |
| first_indexed | 2024-03-08T13:33:58Z |
| format | Article |
| id | doaj.art-fa7d62ea73724d0e9f56e1a9c993c760 |
| institution | Directory Open Access Journal |
| issn | 2666-2450 |
| language | English |
| last_indexed | 2024-03-08T13:33:58Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cerebral Circulation - Cognition and Behavior |
| spelling | doaj.art-fa7d62ea73724d0e9f56e1a9c993c7602024-01-17T04:17:17ZengElsevierCerebral Circulation - Cognition and Behavior2666-24502024-01-016100205Blood pressure variability and white matter hyperintensities after ischemic strokeNina A Hilkens0Frank-Erik de Leeuw1Catharina JM Klijn2Edo Richard3Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands; Corresponding author at: Department of Neurology, Radboudumc Geert Grooteplein Zuid 10 PO Box 9101, 6500 HB Nijmegen, the Netherlands.Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the NetherlandsBackground: High blood pressure variability (BPV) may be a risk factor for stroke and dementia in patients with ischemic stroke, but the underlying mechanism is unknown. We aimed to investigate whether high BPV is associated with presence and progression of white matter hyperintensities (WMH). Methods: We performed a post-hoc analysis on the MRI substudy of the PRoFESS trial, including 771 patients with ischemic stroke who underwent MRI at baseline and after a median of 2.1 years. WMH were rated with a semi-quantitative scale. Visit-to-visit BPV was expressed as the coefficient of variation (interval 3–6 months, median number of visits 7). The association of BPV with WMH burden and progression was assessed with linear and logistic regression analyses adjusted for confounders. Results: BPV was associated with burden of periventricular WMH (β 0.36 95%CI 0.19–0.53, per one SD increase in BPV) and subcortical (log-transformed) WMH (β 0.25, 95%CI 0.08–0.42). BPV was not associated with periventricular (OR 1.09, 95%CI 0.94–1.27) and subcortical WMH progression (OR 1.15, 95%CI 0.99–1.35). Associations were independent of mean BP. Conclusion: High visit-to-visit BPV was associated with both subcortical and periventricular WMH burden in patients with ischemic stroke, but not with WMH progression in this study.http://www.sciencedirect.com/science/article/pii/S2666245024000060Blood pressure variabilityBlood pressureWhite matter hyperintensitiesIschemic stroke |
| spellingShingle | Nina A Hilkens Frank-Erik de Leeuw Catharina JM Klijn Edo Richard Blood pressure variability and white matter hyperintensities after ischemic stroke Cerebral Circulation - Cognition and Behavior Blood pressure variability Blood pressure White matter hyperintensities Ischemic stroke |
| title | Blood pressure variability and white matter hyperintensities after ischemic stroke |
| title_full | Blood pressure variability and white matter hyperintensities after ischemic stroke |
| title_fullStr | Blood pressure variability and white matter hyperintensities after ischemic stroke |
| title_full_unstemmed | Blood pressure variability and white matter hyperintensities after ischemic stroke |
| title_short | Blood pressure variability and white matter hyperintensities after ischemic stroke |
| title_sort | blood pressure variability and white matter hyperintensities after ischemic stroke |
| topic | Blood pressure variability Blood pressure White matter hyperintensities Ischemic stroke |
| url | http://www.sciencedirect.com/science/article/pii/S2666245024000060 |
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