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Reverse‐dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension
Author(s) -
Yan B.,
Peng L.,
Dong Q.,
Zheng F.,
Yang P.,
Sun L.,
Gong S.,
Zeng L.,
Wang G.
Publication year - 2015
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12659
Subject(s) - dipper , medicine , cardiology , confidence interval , ambulatory blood pressure , odds ratio , blood pressure , logistic regression , infarction , lacunar stroke , stroke (engine) , lacunar infarction , myocardial infarction , ischemia , ischemic stroke , mechanical engineering , engineering
Background and purpose The fluctuation of circadian blood pressure ( BP ) is of great diversity in patients with essential hypertension and may provide significant prognostic value for stroke. However, it remains uncertain whether reverse‐dipper pattern of BP influences the incidence of lacunar infarction in hypertensive patients. Methods In the current study, 362 hypertensive patients (195 males, 167 females) were enrolled. BP patterns were evaluated with 24‐h ambulatory BP monitoring ( ABPM ). Multinomial logistic regression was applied to analyse the possible relationships between lacunar infarction and various clinical risk factors such as ABPM . Results A total of 93 patients (25.7%) had reverse‐dipper BP pattern. Non‐dipper pattern of BP was observed in 179 hypertensive patients (49.4%) and dipper pattern in 90 patients (24.9%). The percentage of lacunar infarction was the highest in the patients with reverse‐dipper pattern compared with pure hypertension or atherothrombotic cerebral infarction ( P < 0.05). After multinomial logistic regression analysis, reverse‐dipper pattern of BP (odds ratio 2.492; 95% confidence interval 1.133–5.479; P < 0.05) and age (odds ratio 1.084; 95% confidence interval 1.047–1.123; P < 0.01) were found to be directly associated with lacunar infarction. Conclusions Reverse‐dipper BP pattern may serve as an independent risk factor for lacunar infarction and more personalized BP management should be offered to the patients who have elevated nocturnal BP .