Cerebral small vessel diseases are better associated with ambulatory than office blood pressure measurements: Human neuropathology/imaging‐pathologic correlations. (7th December 2020)

• Record Type: Journal Article
• Authors: Melgarejo, Jesus D.; Gutierrez, Jose; Mena, Luis Javier; Lee, Joseph H.; Chavez, Carlos A.; Calmon, Gustavo; Silva, Egle; Terwilliger, Joseph Douglas; Vanassche, Thomas; Verhamme, Peter; Staessen, Jan; Zhang, Zhen‐Yu; Maestre, Gladys E.
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 2
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.045987
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Cerebral small vessel diseases (CSVD) is a forerunner of cognitive decline, vascular dementia, Alzheimer's disease, and stroke. Which BP index is closest associated with CVSD remains unclear. We aimed this study to examine the association of BP levels, measured by the office and ambulatory BP monitoring (ABPM), with CSVDs, and to determine which BP indexes are better associated with CSVDs. Method: In the Maracaibo Aging Study, 330 participants (73.3% women; mean age, 58.0 years) underwent ABPM, and magnetic resonance brain imaging to assess white matter hyperintensities (WMH), small artery disease (SAD), and silent brain infarcts (SBI), which were divided into total (SBIt), supratentorial (SBIs), and cortical (SBIc). Statistics included multivariable linear and logistic regression. In models including two BP indexes, we uncorrelated these indexes by regressing one index on the other and by using the residual of one BP index. Result: The prevalence of SAD, SBIt, SBIs, and SBIc was 5.8%, 11.8%, 10.1%, and 6.1%; respectively. Multivariable models showed that office, 24‐h, daytime, and nighttime systolic BP (SBP) were significantly associated with WMH, SAD, SBIt, SBIs (P<0.05); all diastolic BP (DBP) indexes were related to WMH, but only nighttime DBP was associated to SAD and SBIs (P<0.05). Adjusted for office SBP, the 24‐h, daytime, and nighttime SBP remained significantly associated with WMH (P<0.01), whereas the opposite was for office SBP after adjustment by 24‐h or daytime SBP. With adjustment for office or daytime SBP, the association between SDA and SBIt with 24‐h and nighttime SBP remained significant (P<0.05); nighttime SBP was additionally related to SBIs. Daytime SBP was not associated with CVSD after adjustments by the office, 24‐h, or nighttime SBP. Adjusted for daytime DBP, nighttime DBP were significantly associated with SDA, SBIi, and SBIs (P<0.05). Conclusion: CSVD was related to 24‐h and nighttime BP. Proper control of the ambulatory BP may reduce the risk for CSVD and associated adverse health outcomes.