Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
PLoS One. 2012;7(12):e52196. doi: 10.1371/journal.pone.0052196. Epub 2012 Dec 19.
BACKGROUND/OBJECTIVES: White matter hyperintensities (WMH) in magnetic resonance imaging (MRI) scans of the brain, and orthostatic hypotension (OH) are both common in older people. We tested the hypothesis that OH is associated with WMH.
Cross-sectional study.
Secondary care outpatient clinics in geriatric medicine and old age psychiatry in western Norway.
160 older patients with mild dementia, diagnosed according to standardised criteria.
OH was diagnosed according to the consensus definition, measuring blood pressure (BP) in the supine position and within 3 minutes in the standing position. MRI scans were performed according to a common protocol at three centres, and the volumes of WMH were quantified using an automated method (n=82), followed by manual editing. WMH were also quantified using the visual Scheltens scale (n=139). Multiple logistic regression analyses were applied, with highest vs. lowest WMH quartile as response.
There were no significant correlations between WMH volumes and systolic or diastolic orthostatic BP drops, and no significant correlations between Scheltens scores of WMH and systolic or diastolic BP drops. In the multivariate analyses, only APOEε4 status remained a significant predictor for WMH using the automated method (p=0.037, OR 0.075 (0.007-0.851)), whereas only age remained a significant predictor for WMH scores (p=0.019, OR 1.119 (1.018-1.230)).
We found no association between OH and WMH load in a sample of older patients with mild dementia.
背景/目的：磁共振成像（MRI）扫描大脑中的脑白质高信号（WMH）和直立性低血压（OH）在老年人中都很常见。我们检验了 OH 与 WMH 相关的假设。
横断面研究。
挪威西部老年医学和老年精神病学的二级保健门诊。
160 名轻度痴呆症患者，根据标准化标准诊断。
OH 根据共识定义诊断，在仰卧位和站立 3 分钟内测量血压（BP）。MRI 扫描按照三个中心的共同方案进行，WMH 体积使用自动方法进行量化（n=82），然后进行手动编辑。WMH 也使用视觉 Scheltens 量表进行量化（n=139）。应用多元逻辑回归分析，以最高与最低 WMH 四分位数为反应。
WMH 体积与收缩期或舒张期直立性 BP 下降之间无显著相关性，WMH 的 Scheltens 评分与收缩期或舒张期 BP 下降之间也无显著相关性。在多变量分析中，仅 APOEε4 状态仍然是使用自动方法预测 WMH 的重要预测因子（p=0.037，OR 0.075（0.007-0.851）），而仅年龄仍然是预测 WMH 评分的重要预测因子（p=0.019，OR 1.119（1.018-1.230））。
我们在轻度痴呆症患者的样本中发现 OH 与 WMH 负荷之间没有关联。
