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Impact of night‐time blood pressure on cerebral white matter hyperintensity in elderly hypertensive patients
Author(s) -
Kokubo Manabu,
Shimizu Atsuya,
Mitsui Toko,
Miyagi Motohiro,
Nomoto Kenichiro,
Murohara Toyoaki,
Toba Kenji,
Sakurai Takashi
Publication year - 2015
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12662
Subject(s) - medicine , blood pressure , cardiology , ambulatory blood pressure , dipper , hyperintensity , atrial fibrillation , dementia , stroke (engine) , ambulatory , population , disease , magnetic resonance imaging , mechanical engineering , environmental health , engineering , radiology
Aim Cerebral white matter hyperintensity ( WMH ) is highly prevalent in the elderly population, and increases the risk of dementia and stroke. We investigated the relationship between ambulatory blood pressure monitoring levels and quantitatively measured WMH volumes among elderly hypertensive patients with well‐controlled blood pressure ( BP ) to re‐evaluated effective hypertension management methods to prevent the progression of WMH . Methods Participants comprised 84 hypertensive patients aged between 65 and 75 years without symptomatic heart failure, ischemic heart disease, atrial fibrillation, stroke or cognitive dysfunction. Results Linear regression analysis showed that office BP was not associated with WMH volume increases. Raised night‐time systolic BP ( P = 0.013) were associated with greater WMH volumes during ambulatory blood pressure monitoring. To clarify the effect of asleep systolic BP on WML volume, we then classified patients into two systolic BP groups as follows: <125 mmHg ( n = 47) and ≥125 mmHg ( n = 37). Baseline characteristics were almost similar in both groups, except the dipper type of circadian BP variation was significantly common in the group with night‐time systolic BP <125 mmHg. However, WMH volume was greater in the group with night‐time systolic BP ≥125 mmHg than that in the <125 mmHg group (9.0 ± 8.4 mL vs 4.1 ± 4.3 mL, P = 0.015). Conclusion Higher night‐time systolic BP levels were observed to contribute greater WMH volumes in elderly hypertensive patients. To prevent the progression of WMH , controlling BP on the basis of ambulatory blood pressure monitoring is important. Geriatr Gerontol Int 2015; 15 (Suppl. 1): 59–65.