Gunstad John, Cohen Ronald A, Tate David F, Paul Robert H, Poppas Athena, Hoth Karin, Macgregor Kristin L, Jefferson Angela L
Kent State University, Kent, Ohio.
Blood Press. 2005;14(6):353-8. doi: 10.1080/08037050500364117.
The present study examined the relationship between multiple blood pressure (BP) indices and white matter hyperintensities (WMH) in a sample of 39 older adults with cardiovascular disease (CVD). Resting BP was measured using an automated monitor every 10 min for 2 h. WMH were quantified on FLAIR images and separate indices were generated for neocortical, periventricular and subcortical brain regions. Correlation analyses revealed systolic BP variability was related to neocortical and total WMH. A function of systolic BP variability and average diastolic pressure showed the strongest relationships, including significant correlation to neocortical, subcortical and total WMH. No BP index was related to WMH in periventricular regions. Exploratory analyses showed only the function of systolic BP variability and average diastolic pressure predicted total WMH, whereas as age, CVD conditions and psychosocial factors did not. These findings demonstrate BP variability is an important contributor to WMH in older adults with CVD and suggests it may have differential relationships to WMH in different brain regions. Additional studies are needed to examine the role of autoregulatory systems in the development of WMH, particularly those using beat-to-beat measures of BP.
本研究在39名患有心血管疾病（CVD）的老年人样本中，检验了多种血压（BP）指标与脑白质高信号（WMH）之间的关系。使用自动监测仪每10分钟测量一次静息血压，持续2小时。在液体衰减反转恢复（FLAIR）图像上对WMH进行定量，并为新皮质、脑室周围和皮质下脑区生成单独的指标。相关性分析显示，收缩压变异性与新皮质和总WMH相关。收缩压变异性与平均舒张压的函数关系显示出最强的相关性，包括与新皮质、皮质下和总WMH的显著相关性。没有血压指标与脑室周围区域的WMH相关。探索性分析表明，只有收缩压变异性与平均舒张压的函数能预测总WMH，而年龄、CVD状况和心理社会因素则不能。这些发现表明，血压变异性是患有CVD的老年人WMH的重要促成因素，并表明它可能与不同脑区的WMH存在不同的关系。需要进一步的研究来检验自动调节系统在WMH发生发展中的作用，特别是那些使用逐搏血压测量的研究。
