Liu Wenjuan, Chen Jing, Li Jia, Hui Ying, Zhang Wenfei, Yang Ling, Ruan Chunyu, Li Jing
Department of Medical Imaging, Aerospace Center Hospital, Beijing, China.
Department of Medical Imaging, Kailuan General Hospital, Tangshan, China.
Clin Neuroradiol. 2025 Aug 5. doi: 10.1007/s00062-025-01543-2.
The relationship between long-term blood pressure factors and cerebral microbleeds (CMBs) in community populations remains unclear. This study aimed to elucidate the associations between various long-term blood pressure factors and the occurrence of CMBs within the Kailuan cohort.
Data were obtained from adults participating in the Multi-Modality Medical Imaging Study Based on the Kailuan Study (META-KLS), a prospective longitudinal community study initiated in 2006, involving participants aged 18-98 years. A total of 752 participants underwent brain magnetic resonance imaging (MRI) between 2021 and 2022. We calculated long-term blood pressure factors, including cumulative exposure, long-term blood pressure variability, and blood pressure trajectories, using established formulas and trajectory models. Linear regression analyses were conducted to examine the associations between these blood pressure factors and the presence of CMBs, adjusting for demographic factors, cardiovascular risk factors, and cerebral blood flow on MRI. Brain MRI outcomes included the presence and classification of CMBs.
A total of 752 participants were included, with a mean age of 56.4 ± 10.8 years. Of these, 448 (59.6%) were men and 304 (40.4%) were women. A diagnosis of CMBs was established in 172 individuals, accounting for 22.9% of the cohort. Cumulative systolic blood pressure (SBP) was identified as an independent risk factor for the occurrence of CMBs (OR = 1.004, 95%CI: 1.002-1.005). This association remained significant after adjusting for sociodemographic and cardiovascular risk factors (OR = 1.002, 95% CI: 1.000-1.004). Participants with deep-type CMBs had significantly higher cumulative SBP compared to those with lobar-type CMBs (P = 0.005). No significant correlations were found between the occurrence of CMBs and cumulative diastolic blood pressure (DBP), cumulative pulse pressure difference, blood pressure trajectories, or long-term blood pressure variability.
In community population, elevated cumulative SBP is an important risk factor for CMBs, particularly affecting deep brain tissue.
社区人群中长期血压因素与脑微出血（CMBs）之间的关系尚不清楚。本研究旨在阐明开滦队列中各种长期血压因素与CMBs发生之间的关联。
数据来自参与基于开滦研究的多模态医学影像研究（META-KLS）的成年人，这是一项于2006年启动的前瞻性纵向社区研究，涉及18至98岁的参与者。2021年至2022年期间，共有752名参与者接受了脑磁共振成像（MRI）检查。我们使用既定公式和轨迹模型计算了长期血压因素，包括累积暴露、长期血压变异性和血压轨迹。进行线性回归分析以检验这些血压因素与CMBs存在之间的关联，并对人口统计学因素、心血管危险因素和MRI上的脑血流量进行了调整。脑MRI结果包括CMBs的存在情况和分类。
共纳入752名参与者，平均年龄为56.4±10.8岁。其中，男性448名（59.6%），女性304名（40.4%）。172人被诊断为CMBs，占队列的22.9%。累积收缩压（SBP）被确定为CMBs发生的独立危险因素（OR = 1.004，95%CI：1.002 - 1.005）。在调整社会人口统计学和心血管危险因素后，这种关联仍然显著（OR = 1.002，95%CI：1.000 - 1.004）。与叶型CMBs患者相比，深部型CMBs患者的累积SBP显著更高（P = 0.005）。未发现CMBs的发生与累积舒张压（DBP）、累积脉压差、血压轨迹或长期血压变异性之间存在显著相关性。
在社区人群中，累积SBP升高是CMBs的重要危险因素，尤其影响深部脑组织。
