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Relationships between blood pressure variability and silent cerebral infarction in patients with primary hypertension

Artery Research volume 24, pages 40–46 (2018)Cite this article

Abstract

Aims

This study aimed to investigate the relationship between blood pressure variability and the incidence of silent cerebral infarction (SCI) in patients with primary hypertension.

Methods

The 346 hospitalized patients with primary hypertension were divided into primary hypertension group (160 cases) and primary hypertension combined with SCI group (186 cases). The 24-h ambulatory blood pressure was measured. Clinical data were collected. Univariate and multivariate logistic regression analysis was performed.

Results

There were significant differences between patients with primary hypertension combined with SCI and patients with primary hypertension only in age, stroke history, diabetes history, smoking, alcohol consumption, FBG, Hcy, and Lp-PLA2. The 24-h ambulatory blood pressure monitoring results suggested that dSBP, dSSD, 24hSBP, nSSD, dDBP, dDSD, nDSD, 24hDSD, ddnSBP, and ddnDBP in patients with hypertension and SCI were higher than those in patients with primary hypertension only. Non-dipper blood pressure was more common. Multivariate logistic regression analysis showed dSSD (OR: 1.374, 95%CI [1.173–1.609]), 24 h DSD (OR: 1.194, 95%CI [1.017,1.402]), dSBP (OR: 1.062, 95%CI [1.022, 1.103]), age (OR: 1.042, 95%CI [1.005, 1.080]), smoking (OR: 2.610, 95%CI [1.495, 4.556]), fasting plasma glucose (OR: 1.183, 95%CI [1.040, 1.345]), and Lp-PLA2 (OR: 1.004, 95%CI [1.003, 1.006]) were positively correlated with SCI in hypertension patients.

Conclusions

Blood pressure variability (dSSD and24hDSD) is independently associated with SCI in patients with primary hypertension. In addition, traditional risk factors, blood pressure level (dSBP), age, smoking, fasting plasma glucose, and Lp-PLA2 were also independently associated with SCI in patients with primary hypertension.

References

  1. Parati G, Ochoa JE, Lombardi C, Bilo G. Blood pressure variability: assessment, predictive value, and potential as a therapeutic target. Curr Hypertens Rep 2015;17(4):537.

    Google Scholar 

  2. Veloudi P, Blizzard CL, Head GA, Abhayaratna WP, Stowasser M, Sharman JE. Blood pressure variability and prediction of target organ damage in patients with uncomplicated hypertension. Am J Hypertens 2016;29(9):1046–54.

    Google Scholar 

  3. Irigoyen MC, De Angelis K, Dos Santos F, Dartora DR, Rodrigues B, Consolim-Colombo FM. Hypertension, blood pressure variability, and target organ lesion. Curr Hypertens Rep 2016;18(4):31.

    Google Scholar 

  4. Choi HJ. Blood pressure variability and its management in hypertensive patients. Korean J Fam Med 2012;33(6):330–5.

    Google Scholar 

  5. Rothwell PM, Howard SC, Dolan E, O’Brien E, Dobson JE, Dahlo¨f B, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet 2010;375(9718):895–905.

    Google Scholar 

  6. Parati G, Ochoa JE, Lombardi C, Bilo G. Assessment and management of blood-pressure variability. Nat Rev Cardiol 2013; 10(3):143–55.

    Google Scholar 

  7. Leoncini G, Viazzi F, Storace G, Deferrari G, Pontremoli R. Blood pressure variability and multiple organ damage in primary hypertension. J Hum Hypertens 2013;27(11):663–70.

    Google Scholar 

  8. Fanning JP, Wong AA, Fraser JF. The epidemiology of silent brain infarction: a systematic review of population-based cohorts. BMC Med 2014;12:119.

    Google Scholar 

  9. Yi CC, Zhang YQ, Liu WW, Guo ZJ, Yin RF. Prevalence and risk factors of silent cerebral infarction in a Chinese population. Acad J Sec Military Med Univ 2011;32:537–40.

    Google Scholar 

  10. Gupta A, Giambrone AE, Gialdini G, Finn C, Delgado D, Gutierrez J, et al. Silent brain infarction and risk of future stroke: a systematic review and meta-analysis. Stroke 2016; 47(3):719–25.

    Google Scholar 

  11. Chi X, Li M, Zhan X, Man H, Xu S, Zheng D, et al. Relationship between carotid artery sclerosis and blood pressure variability in essential hypertension patients. Comput Biol Med 2018;92:73–7.

    Google Scholar 

  12. Armstrong C, Joint National Committee. JNC8 guidelines for the management of hypertension in adults. Am Fam Physician 2014;90(7):503–4.

    Google Scholar 

  13. Pascot R, Daoudal A, Cardon A, Godet G, Lucas A, Clochard E, et al. Evaluation by magnetic resonance imaging of silent brain infarcts in preoperative and postoperative asymptomatic carotid surgery. Ann Vasc Surg 2017;43:258–64.

    Google Scholar 

  14. Fukuda K, Kai H, Kamouchi M, Hata J, Ago Y, Nakane H, et al. Day-by-Day blood pressure variability and functional outcome after acute ischemic stroke: fukuoka stroke registry. Stroke 2015;46(7):1832–9.

    Google Scholar 

  15. Manning LS, Rothwell PM, Potter JF, Robinson TG. Prognostic significance of short-term blood pressure variability in acute stroke: systematic review. Stroke 2015;46(9):2482–90.

    Google Scholar 

  16. Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013;44(7):2064–89.

    Google Scholar 

  17. Mulvany MJ. Small artery remodeling in hypertension. Basic Clin Pharmacol Toxicol 2012;110(1):49–55.

    Google Scholar 

  18. Savoia C, Battistoni A, Calvez V. Microvascular alterations in hypertension and vascular aging. Curr Hypertens Rev 2017; 13(1):16–23.

    Google Scholar 

  19. Das RR, Seshadri S, Beiser AS, Kelly-Hayes M, Au R, Himali JJ, et al. Prevalence and correlates of silent cerebral infarcts in the Framingham offspring study. Stroke 2008;39(11):2929–35.

    Google Scholar 

  20. Li RY, Cao ZG, Li Y, Wang RT. Increased whole blood viscosity is associated with silent cerebral infarction. Clin Hemorheol Microcirc 2015;59(4):301–7.

    Google Scholar 

  21. Castilla-Guerra LI, Fernández-Moreno Mdel C. Update on the management of hypertension for secondary stroke prevention. Eur Neurol 2012;68(1):1–7.

    Google Scholar 

  22. Moroni F, Ammirati E, Magnoni M, Man H, Xu S, Zheng D, et al. Carotid atherosclerosis, silent ischemic brain damage and brain atrophy: a systematic review and meta-analysis. Int J Cardiol 2016;223:681–7.

    Google Scholar 

  23. Chen X, Wei L. Progress in research of silent brain infarction. Clin Misdiagn Misther 2010;30(23):3604–6.

    Google Scholar 

  24. Li Y, Liu N, Huang Y, Wei W, Cheng F, Zhang W. Risk factors for silent lacunar infarction in patients with transient ischemic attack. Med Sci Mon Int Med J Exp Clin Res 2016;22:447–53.

    Google Scholar 

  25. Jayasooriya G, Thapar A, Shalhoub J, Davies AH. Silent cerebral events in asymptomatic carotid stenosis. J Vasc Surg 2011; 54(1):227–336.

    Google Scholar 

  26. Riba-Llena I, Penalba A, Pelegrí D, et al. Role of lipoprotein-associated phospholipase A2 activity for the prediction of silent brain infarcts in women. Atherosclerosis 2014;237(2): 811–5.

    Google Scholar 

  27. MEHMET Yi-ming, JIN Hai-yan, CHEN Bo, DE Mi-na. Relationship between blood pressure variability and asymptomatic cerebral infarction in patients with hypertension in Kashgar. South China J Cardiovas Dis 2015.

  28. Zhang Li, Li Yan. Study on the relationship between blood pressure variability and senile asymptomatic cerebrovascular damage. Chin J Postgrad Med 2014;37(28):43–6.

    Google Scholar 

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Author notes

  1. These authors contribute equally for this paper.

Authors and Affiliations

  1. Department of Neurology, Weihai Central Hospital Affiliated to Qingdao University, 264400, Weihai, China

    Xianglin Chi, Zhaorong Guo & Honghao Man

  2. School of Instrument Science and Engineering, Southeast University, 210096, Nanjing, China

    Xingyao Wang & Chengyu Liu

  3. Department of Cardiology, Shandong University Qilu Hospital, 266035, Qingdao, China

    Hongxiao Xu & Yingcui Wang

Authors
  1. Xianglin Chi
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  2. Xingyao Wang
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  3. Zhaorong Guo
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  4. Honghao Man
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  5. Hongxiao Xu
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  6. Yingcui Wang
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  7. Chengyu Liu
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Corresponding authors

Correspondence to Honghao Man, Hongxiao Xu or Chengyu Liu.

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This is an open access article distributed under the CC BY-NC license https://doi.org/creativecommons.org/licenses/by/4.0/.

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Chi, X., Wang, X., Guo, Z. et al. Relationships between blood pressure variability and silent cerebral infarction in patients with primary hypertension. Artery Res 24, 40–46 (2018). https://doi.org/10.1016/j.artres.2018.11.001

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  • DOI: https://doi.org/10.1016/j.artres.2018.11.001

Keywords

Artery Research

ISSN: 1876-4401

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