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Table of Contents
Vol. 19, No. 5, 2005
Issue release date: April 2005
Section title: Original Paper
Cerebrovasc Dis 2005;19:302–308
(DOI:10.1159/000084498)

The Relationship between 24-Hour Blood Pressure Readings, Subcortical Ischemic Lesions and Vascular Dementia

Yamamoto Y.a · Akiguchi I.b · Oiwa K.a · Hayashi M.a · Ohara T.a · Ozasa K.c
aDepartment of Neurology, Kyoto Second Red Cross Hospital, bDepartment of Neurology, Kyoto Takeda Hospital, cDepartment of Social Medicine and Cultural Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: September 15, 2004
Accepted: November 25, 2004
Published online: April 28, 2005
Issue release date: April 2005

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Background: Twenty-four-hour blood pressure (BP) readings have been found to correlate with hypertensive target organ damage. Lacunar infarcts (LI) and white matter lesions (WML) probably represent manifestations of cerebral hypertensive target organ damage. This study was conducted to better delineate the relationships between 24-hour BP measurements, LI/WML and small vessel disease cognitive impairment/vascular dementia (CI/VD). Methods: Two hundred patients with first-time symptomatic LI were examined with 24-hour BP monitoring. The degree of nocturnal BP dip, (daytime BP – nighttime BP)/daytime BP, was categorized into three groups: dippers (>0.1), nondippers (0–0.1) and reverse dippers (<0). WML were subdivided into periventricular hyperintensities (PVH) and subcortical hyperintensities. Results: The breakdown of patients was: 50% nondippers, 27.5% reverse dippers and 22.5% dippers. Forty-one patients (20.5%) were found to have CI and dementia. Male sex (OR 3.35; 95% CI 1.20–9.34), advanced PVH (OR 14.42; 95% CI 5.62–36.98) and absence of a dipping status (nondipper: OR 12.62; 95% CI 1.37–115.95; reverse dipper: OR 11.95; 95% CI 1.27–112.11) were independently associated with CIVD after multivariate analysis. High nighttime systolic BP (OR 3.93; 95% CI 1.38–11.17), high daytime (OR 2.06; 95% CI 1.03–4.04) and nighttime diastolic BP (OR 2.48; 95% CI 1.13–5.45) and absence of a dipping status (nondipper: OR 2.7; 95% CI 1.03–7.05; reverse dipper: OR 3.78; 95% CI 1.38–10.34) were significantly associated with PVH. Conclusions: High prevalence of a nondipping status was found in the LI cohort. A nondipping status appears to be directly associated with CIVD independent of PVH. This study indicates the need for further studies to investigate whether or not controlling nighttime BP will help reduce the risk for CI/VD development.

© 2005 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: September 15, 2004
Accepted: November 25, 2004
Published online: April 28, 2005
Issue release date: April 2005

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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