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- Title
Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis.
- Authors
Kim, Bum Joon; Kwon, Sun U; Park, Jong-Moo; Hwang, Yang-Ha; Heo, Sung Hyuk; Rha, Joung-Ho; Lee, Jun; Park, Man-Seok; Kim, Joon-Tae; Song, Hee-Jung; Park, Jong-Ho; Yu, Sungwook; Lee, Soo Joo; Park, Tai Hwan; Cha, Jae-Kwan; Kwon, Hyung-Min; Kim, Eung-Gyu; Lee, Seung-Hoon; Lee, Ji Sung; Lee, Juneyoung
- Abstract
BACKGROUND High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS). METHODS This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50% stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs. RESULTS Of the 111 enrolled patients, 69 patients (67.6%) demonstrated WML growth and 15 patients (13.7%) had NILs. Patients with higher BPV demonstrated a more WML growth (50% vs. 61.8% vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4% vs. 5.4% vs. 29.7%; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95% confidence interval (CI) = 1.005–1.101); P = 0.03] and home BPV [OR = 1.149 (95% CI = 1.013–1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95% CI = 0.874–0.984); P = 0.02] and high home BPV [OR = 1.287 (95% CI = 1.086–1.526); P = 0.004] were independently associated with NILs at follow-up. CONCLUSIONS High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.
- Subjects
BLOOD pressure; HYPERTENSION; STROKE; ATHEROSCLEROSIS; STROKE patients
- Publication
American Journal of Hypertension, 2019, Vol 32, Issue 9, p918
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpz068