Night-time systolic blood pressure and subclinical cerebrovascular disease: the Cardiovascular Abnormalities and Brain Lesions (CABL) study

Although ambulatory blood pressure (BP) is a better predictor of cardiovascular outcomes than office BP, its association with subclinical cerebrovascular disease is not clarified. We investigated the associations of office and ambulatory BP values with subclinical cerebrovascular disease in a popula...

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Published in:European heart journal cardiovascular imaging 2019-07, Vol.20 (7), p.765-771
Main Authors: Nakanishi, Koki, Jin, Zhezhen, Homma, Shunichi, Elkind, Mitchell S V, Rundek, Tatjana, Schwartz, Joseph E, Lee, Tetz C, Tugcu, Aylin, Yoshita, Mitsuhiro, DeCarli, Charles, Wright, Clinton B, Sacco, Ralph L, Di Tullio, Marco R
Format: Article
Language:English
Subjects:
Aged
Blood Pressure Monitoring, Ambulatory
Cerebrovascular Disorders - diagnostic imaging
Cerebrovascular Disorders - physiopathology
Circadian Rhythm
Echocardiography
Editor's Choice
Female
Florida
Humans
Magnetic Resonance Imaging
Male
Middle Aged
New York City
Original
Predictive Value of Tests
Risk Factors
Systole
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Summary:Although ambulatory blood pressure (BP) is a better predictor of cardiovascular outcomes than office BP, its association with subclinical cerebrovascular disease is not clarified. We investigated the associations of office and ambulatory BP values with subclinical cerebrovascular disease in a population based, predominantly elderly cohort without prior stroke. Eight hundred and twenty-eight participants underwent 24-h ambulatory BP monitoring (ABPM), 2D echocardiography and brain magnetic resonance imaging in the Cardiac Abnormalities and Brain Lesion (CABL) study. Daytime, night-time, and 24-h BPs, nocturnal dipping pattern, morning surge (MS), and 24-h variability were assessed. Subclinical cerebrovascular disease was defined as silent brain infarcts (SBIs) and white matter hyperintensity volume (WMHV). The association of BP measures with the presence of SBI and upper quartile of log-WMHV (log-WMHV4) was analysed. SBIs were detected in 111 patients (13.4%). Mean log-WMHV was -0.99 ± 0.94. In multivariable analysis, only night-time systolic BP (SBP) was significantly associated with SBI [odds ratio (OR) 1.15 per 10 mmHg, P = 0.042], independent of cardiovascular risk factors, and pertinent echocardiographic parameters. Although daytime, night-time, 24-h BPs, and non-dipping pattern were all significantly associated with log-WMHV4 (all P 
ISSN:2047-2404
2047-2412
DOI:10.1093/ehjci/jey221