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Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis

Authors
Kim, Bum JoonKwon, Sun U.Park, Jong-MooHwang, Yang-HaHeo, Sung HyukRha, Joung-HoLee, JunPark, Man-SeokKim, Joon-TaeSong, Hee-JungPark, Jong-HoYu, SungwookLee, Soo JooPark, Tai HwanCha, Jae-KwanKwon, Hyung-MinKim, Eung-GyuLee, Seung-HoonLee, Ji SungLee, JuneyoungKang, Dong-Wha
Issue Date
9월-2019
Publisher
OXFORD UNIV PRESS
Keywords
blood pressure; blood pressure variability; hypertension; intracranial atherosclerosis; white matter lesion
Citation
AMERICAN JOURNAL OF HYPERTENSION, v.32, no.9, pp.918 - 924
Indexed
SCIE
SCOPUS
Journal Title
AMERICAN JOURNAL OF HYPERTENSION
Volume
32
Number
9
Start Page
918
End Page
924
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/63399
DOI
10.1093/ajh/hpz068
ISSN
0895-7061
Abstract
BACKGROUND High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS). METHODS This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50% stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs. RESULTS Of the 111 enrolled patients, 69 patients (67.6%) demonstrated WML growth and 15 patients (13.7%) had NILs. Patients with higher BPV demonstrated a more WML growth (50% vs. 61.8% vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4% vs. 5.4% vs. 29.7%; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95% confidence interval (CI) = 1.005-1.101); P = 0.03] and home BPV [OR = 1.149 (95% CI = 1.013-1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95% CI = 0.874-0.984); P = 0.02] and high home BPV [OR = 1.287 (95% CI = 1.086-1.526); P = 0.004] were independently associated with NILs at follow-up. CONCLUSIONS High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.
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