Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 25:14:1200846.
doi: 10.3389/fneur.2023.1200846. eCollection 2023.

Correlation of blood pressure levels at different time periods throughout the day with total CSVD burden and MRI imaging markers

Hua Yang #  1   2 , Xueyi Fan #  1   3 , Xiangyi Shen #  4 , Li Liang  1   2 , Dongyang Hu  1 , Yimo Zhang  1 , Li Liu  5 , Hairong Qian  1   2   3   6
Affiliations

Correlation of blood pressure levels at different time periods throughout the day with total CSVD burden and MRI imaging markers

Hua Yang et al. Front Neurol. .

Abstract

Purpose: Hypertension is an important risk factor for atherosclerotic cerebral small vessel disease (CSVD). Higher blood pressure is associated with a higher CSVD burden and the presence of relevant magnetic resonance imaging (MRI) markers. However, the effect of blood pressure level on CSVD burden and imaging markers including white matter hyperintensity (WHM), lacune, enlarged perivascular spaces (EPVS), and cerebral microbleed (CMB) remains unknown. The purpose of this study was to investigate the correlation between blood pressure level and CSVD burden at different time periods throughout the day.

Methods: In total, 144 in-patients with CSVD (66.4 ± 9.8 years, 50% male) were enrolled and underwent brain MRI, and 24-h ambulatory blood pressure was assessed. Patients were categorized into five groups according to their MRI-evaluated total CSVD burden scores (0-4). Spearman's correlation analysis was performed to examine the correlation between blood pressure levels at different time periods and the total CSVD score or the markers of periventricular WMH, deep WMH, lacune, EPVS, and CMB.

Results: Of the 144 patients, 83.3% (120/144) harbored one or more CSVD markers of interest. The systolic blood pressure (SBP) of 24-h, daytime, nighttime, and morning differed significantly among the five groups. The SBP levels increased significantly with the total CSVD scores during 24 h (P = 0.018), daytime (P = 0.018), and nighttime (P = 0.035). Spearman's correlation analysis demonstrated that the SBP of 24 h, daytime, nighttime, and morning and the diastolic blood pressure (DBP) of 24 h and morning positively and significantly correlated with the total CSVD score (P < 0.05). A logistic regression analysis indicated that both morning SBP and DBP were independent risk factors for total CSVD burden (OR = 1.13, 95% CI: 1.02-1.23, P = 0.015; OR = 1.19, 95% CI: 1.06-1.33, P = 0.005). Spearman's correlation analysis indicated a significant positive correlation between morning SBP and higher deep WMH Fazekas score (r = 0.296, P < 0.001), EPVS grade in the basal ganglia (r = 0.247, P = 0.003), and the presence of lacune (r = 0.173, P = 0.038) and CMB (r = 0.326, P < 0.001). Morning DBP only correlated positively with the presence of CMB (r = 0.292, P < 0.001).

Conclusion: Higher SBP signficantly correlated with total CSVD burden in patients with atherosclerotic CSVD. Early morning blood pressure level is an important indicator to reflect the severity of CSVD patients.

Keywords: MRI marker; ambulatory blood pressure monitoring; blood pressure; cerebral small vessel disease; total burden score.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer XS declared a shared affiliation with the authors HY, LLia, and HQ to the handling editor at the time of review.

Figures

Figure 1
Figure 1
Flow chart of enrollment in the current study.
Figure 2
Figure 2
(A–D) Blood pressure levels at different time periods in different total CSVD burden score groups.
Figure 3
Figure 3
Linear regression results between total CSVD burden scores and blood pressure levels at different time periods.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Thomas T, Miners S, Love S. Post-mortem assessment of hypoperfusion of cerebral cortex in Alzheimer's disease and vascular dementia. Brain. (2015) 138:1059–69. 10.1093/brain/awv025 - DOI - PubMed
    1. Zanon Zotin MC, Sveikata L, Viswanathan A, Yilmaz P. Cerebral small vessel disease and vascular cognitive impairment: from diagnosis to management. Curr Opin Neurol. (2021) 34:246–57. 10.1097/wco.0000000000000913 - DOI - PMC - PubMed
    1. Staals J, Makin SD, Doubal FN, Dennis MS, Wardlaw JM. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology. (2014) 83:1228–34. 10.1212/wnl.0000000000000837 - DOI - PMC - PubMed
    1. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol. (2010) 9:689–701. 10.1016/s1474-4422(10)70104-6 - DOI - PubMed
    1. Bezerra DC, Sharrett AR, Matsushita K, Gottesman RF, Shibata D, Mosley TH, et al. . Risk factors for lacune subtypes in the atherosclerosis risk in communities (ARIC) study. Neurology. (2012) 78:102–8. 10.1212/WNL.0b013e31823efc42 - DOI - PMC - PubMed

LinkOut - more resources