Blood Pressure Rhythm and Blood Pressure Variability as Risk Factors for White Matter Lesions: A Cross-Sectional Study

Abstract

BACKGROUND White matter lesions are common in the elderly. The aim of this study was to explore the correlation between blood pressure rhythm and blood pressure variability with white matter lesions. MATERIAL AND METHODS A total of 144 subjects aged 40 to 80 years underwent MRI scanning to assess the degree of white matter lesions using the Fazekas scale. The regional cerebral blood flow was detected by brain perfusion imaging, and an ambulatory blood pressure monitor was used to measure the circadian blood pressure rhythm. Odds ratio and the 95% confidence interval was computed using logistics regression analysis. The relationship between various factors and blood pressure was calculated by curve simulation. RESULTS With the increase of white matter lesions, the regional cerebral blood flow at the lesion decreased gradually. Systolic blood pressure day/night difference ratio (OR=0.815, 95% CI 0.729-0.910), diastolic blood pressure day/night difference ratio (OR=0.895, 95% CI 0.831-0.964), systolic blood pressure coefficient of variation (OR=1.589, 95% CI 1.273-1.983), and diastolic blood pressure coefficient of variation (OR=1.363, 95% CI 1.150-1.616) were significantly associated with Fazekas score (P<0.05 for all). CONCLUSIONS Greater blood pressure variability and blood pressure rhythm disorders were associated with lower regional cerebral blood flow in patients with white matter lesions.

Figure 1

(A–D) Quadratic curve of blood pressure rhythm and rCBF. SBPDNR – systolic blood pressure day/night difference ratio; DBPDNR – diastolic blood pressure day/night difference ratio; MPCBF – mean periventricular cerebral blood flow; MSCBF – mean subcortical cerebral blood flow; SPSS Statistics 26 IBM.

Figure 2

(A–D) Quadratic curve of blood pressure variability coefficient and rCBF. SBPCV – systolic blood pressure coefficient of variation; DBPCV – diastolic blood pressure coefficient of variation; MPCBF – mean periventricular cerebral blood flow; MSCBF – mean subcortical cerebral blood flow; SPSS Statistics 26 IBM.

Figure 3

(A–D) Relationship between MoCA and blood pressure. SBPDNR – systolic blood pressure day/night difference ratio; DBPDNR – diastolic blood pressure day/night difference ratio; SBPCV – systolic blood pressure coefficient of variation; DBPCV – diastolic blood pressure coefficient of variation; SPSS Statistics 26 IBM.

Figure 4

(A, B) Relationship between MoCA and cerebral blood flow. MPCBF – mean periventricular cerebral blood flow; MSCBF – mean subcortical cerebral blood flow; SPSS Statistics 26 IBM.