Blood Pressure Rhythm and Blood Pressure Variability as Risk Factors for White Matter Lesions: A Cross-Sectional Study

Abstract

Background White matter lesions are common in the elderly. The aim of this study was to explore the correlation between blood pressure rhythm and blood pressure variability with white matter lesions. Material/Methods A total of 144 subjects aged 40 to 80 years underwent MRI scanning to assess the degree of white matter lesions using the Fazekas scale. The regional cerebral blood flow was detected by brain perfusion imaging, and an ambulatory blood pressure monitor was used to measure the circadian blood pressure rhythm. Odds ratio and the 95% confidence interval was computed using logistics regression analysis. The relationship between various factors and blood pressure was calculated by curve simulation. Results With the increase of white matter lesions, the regional cerebral blood flow at the lesion decreased gradually. Systolic blood pressure day/night difference ratio (OR=0.815, 95% CI 0.729–0.910), diastolic blood pressure day/night difference ratio (OR=0.895, 95% CI 0.831–0.964), systolic blood pressure coefficient of variation (OR=1.589, 95% CI 1.273–1.983), and diastolic blood pressure coefficient of variation (OR=1.363, 95% CI 1.150–1.616) were significantly associated with Fazekas score ( P <0.05 for all). Conclusions Greater blood pressure variability and blood pressure rhythm disorders were associated with lower regional cerebral blood flow in patients with white matter lesions.

Risk Factors and Clinical Characteristics of First-ever Ischemic Stroke Caused by ICAS with Leukoaraiosis

“…In hypertensive patients, blood pressure variability and impaired blood pressure rhythm resulting in reduced localized blood flow to the white matter of the brain may be an essential cause of LA. Both acute and chronic elevated blood pressure leads to systemic adaptive vascular remodeling, causing damage to multiple end organs, including the brain 23 - 24 . Recently, relevant studies have shown that in adults with hypertension, patients with systolic blood pressure less than 120 mmHg (intensive hypotension) had a smaller increase in the volume of cerebral white matter lesions and a greater decrease in total brain volume compared to patients with systolic blood pressure less than 140 mmHg 25 .…”

Impact of blood pressure variability and cerebral small vessel disease: A systematic review and meta-analysis

“…We found that both SBPV and DBPV can promote WMH development. In addition, by studying the relationship between Blood pressure CV and WMH, Zhang et al found that systolic blood pressure CV (OR = 1.589,95 % CI 1.273–1.983) and diastolic blood pressure CV (OR = 1.363,95 % CI 1.150–1.616) were significantly correlated with Fazekas score (P < 0.05) [ 43 ]. Moreover, some studies have further pointed out that both short-term SBPV and long-term SBPV cause varying degrees of damage to WMH [ 32 , 44 ].…”

Current and Future Developments in Imaging and Treatment of White Matter Disease: A Systematic Review

“…Blood pressure rhythm (BPR) and blood pressure variability (BPV) increase the risk of WMLs, which have recently been linked to hypertension and aging. Reducing regional cerebral blood flow was associated with increased BPV and rhythm abnormalities in individuals with WMLs [ 9 ], indicating that disruptions in BPR or increased BPV may impede WML advancement through this mechanism.…”