Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
Blood Press. 2024 Dec;33(1):2314498. doi: 10.1080/08037051.2024.2314498. Epub 2024 Mar 13.
There is evidence that blood pressure variability (BPV) is associated with cerebral small vessel disease (SVD) and may therefore increase the risk of stroke and dementia. It remains unclear if BPV is associated with SVD progression over years. We examined whether visit-to-visit BPV is associated with white matter hyperintensity (WMH) progression over 14 years and MRI markers after 14 years. We included participants with SVD from the Radboud University Nijmegen Diffusion tensor Magnetic resonance-imaging Cohort (RUNDMC) who underwent baseline assessment in 2006 and follow-up in 2011, 2015 and 2020. BPV was calculated as coefficient of variation (CV) of BP at all visits. Association between WMH progression rates over 14 years and BPV was examined using linear-mixed effects (LME) model. Regression models were used to examine association between BPV and MRI markers at final visit in participants. A total of 199 participants (60.5 SD 6.6 years) who underwent four MRI scans and BP measurements were included, with mean follow-up of 13.7 (SD 0.5) years. Systolic BPV was associated with higher progression of WMH ( = 0.013, 95% CI 0.005 - 0.022) and higher risk of incident lacunes (OR: 1.10, 95% CI 1.01-1.21). There was no association between systolic BPV and grey and white matter volumes, Peak Skeleton of Mean Diffusivity (PSMD) or microbleed count after 13.7 years. Visit-to-visit systolic BPV is associated with increased progression of WMH volumes and higher risk of incident lacunes over 14 years in participants with SVD. Future studies are needed to examine causality of this association.
有证据表明，血压变异性（BPV）与脑小血管疾病（SVD）有关，因此可能会增加中风和痴呆的风险。目前尚不清楚 BPV 是否与多年来 SVD 的进展有关。我们研究了随访期间的 BPV 是否与 14 年内的脑白质高信号（WMH）进展以及 14 年后的 MRI 标志物有关。我们纳入了 Radboud 大学 Nijmegen 弥散张量磁共振成像队列（RUNDMC）中的 SVD 参与者，他们在 2006 年进行了基线评估，随后在 2011 年、2015 年和 2020 年进行了随访。所有随访时的 BPV 均通过血压变异系数（CV）来计算。采用线性混合效应（LME）模型来检验 WMH 进展率与 BPV 之间的相关性。回归模型用于检验参与者最终随访时的 BPV 与 MRI 标志物之间的关系。共纳入 199 名参与者（60.5±6.6 岁），他们进行了 4 次 MRI 扫描和血压测量，平均随访 13.7（0.5 年）。收缩压变异性与 WMH 进展程度更高相关（β=0.013，95%置信区间 0.005-0.022），腔隙性梗死的风险也更高（OR：1.10，95%置信区间 1.01-1.21）。在经过 13.7 年后，收缩压变异性与灰质和白质体积、峰值平均弥散峰度（PSMD）或微出血数量均无相关性。SVD 患者的收缩压变异性与 WMH 体积的增加和 14 年内腔隙性梗死的风险增加有关。需要进一步的研究来检验这种关联的因果关系。
