Gao Yang, Deng Weiping, Sun Jialan, Yue Dongqi, Zhang Bei, Feng Yulan, Han Jun, Shen Fanxia, Hu Jin, Fu Yi
Department of Neurology, The First Hospital of Jiaxing and The Affiliated Hospital of Jiaxing University, Jiaxing, China.
Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Neurol. 2022 May 23;13:879764. doi: 10.3389/fneur.2022.879764. eCollection 2022.
Nocturnal blood pressure dipping patterns have been associated with an increased risk of Cerebral Small Vessel Disease (CSVD), which has not been well-studied. This study is aimed to explore the association of dipping patterns and other factors with lacunes and enlarged perivascular spaces (EPVS) in patients with hypertension.
We enrolled a total of 1,322 patients with essential hypertension in this study. Magnetic resonance imaging (MRI) scans and 24-h ambulatory blood pressure (BP) monitoring were completed. Nocturnal BP decline was calculated, and then dipping patterns were classified. Patients were classified into four groups according to the performance of lacunes and EPVS in the MRI scan for statistical analysis.
(1) Nocturnal BP decline showed independent negative correlation with both lacunes and EPVS while mean systolic BP (mSBP) level showed an independent positive correlation with them ( < 0.05). (2) The frequency of reverse-dippers in the control group was significantly lower than that in other groups; the frequency of non-dippers in the lacunes group and EPVS group was significantly lower than that in the control group; the frequency of extreme-dippers in the EPVS group was significantly higher than that in the mixed (lacunes with EPVS) group ( < 0.05).
Both mSBP and dipping patterns might play an important role in developing lacunes and EPVS in patients with hypertension.
夜间血压下降模式与脑小血管疾病（CSVD）风险增加有关，但对此研究尚不充分。本研究旨在探讨高血压患者中血压下降模式及其他因素与腔隙性脑梗死和血管周围间隙增宽（EPVS）的关系。
本研究共纳入1322例原发性高血压患者。完成磁共振成像（MRI）扫描和24小时动态血压（BP）监测。计算夜间血压下降情况，然后对血压下降模式进行分类。根据MRI扫描中腔隙性脑梗死和EPVS的表现将患者分为四组进行统计分析。
（1）夜间血压下降与腔隙性脑梗死和EPVS均呈独立负相关，而平均收缩压（mSBP）水平与它们呈独立正相关（<0.05）。（2）对照组中反勺型血压者的频率显著低于其他组；腔隙性脑梗死组和EPVS组中非勺型血压者的频率显著低于对照组；EPVS组中极端勺型血压者的频率显著高于混合组（腔隙性脑梗死合并EPVS）（<0.05）。
mSBP和血压下降模式可能在高血压患者腔隙性脑梗死和EPVS的发生中起重要作用。
