ABSTRACT
Objective To investigate the correlation between 24-h ambulatory blood pressure variability and the overall burden of cerebral small vessel disease (CSVD) in patients with acute ischemic stroke. Methods From March 2016 to December 2017, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, the Affiliated Changshu Hospital of Soochow University were enrolled. The 3. 0 T-MRI was used to assess asymptomatic lacunar infarction, white matter hyperintensities, cerebral microbleeds, and enlarged perivascular spaces within 24 h after admission, and the total CSVD score (0-4) was calculated. 24-h ambulatory blood pressure monitoring was performed 24 to 72 h after admission. Ordinal logistic regression analysis was used to determine the independent correlation between the 24-h ambulatory blood pressure-related index and the total CSVD score. Results A total of 220 patients with acute ischemic stroke were enrolled. The patients were divided into five groups according to the total CSVD score. Univariate analysis showed that there were significant differences in age, homocysteine, the proportion of hypertension, as well as 24 h, daytime and nighttime mean systolic blood pressure (SBP), and coefficient of variation of daytime SBP among the 5 groups (all P < 0. 05). Ordinal logistic regression analysis showed that age (odds ratio [OR] 1. 078, 95％ confidence interval [CI] 1. 051-1. 106; P < 0. 001), 24-h mean SBP (OR 1. 043, 95％ CI 1. 026-1. 060; P < 0. 001), daytime mean SBP (OR 1. 042, 95％ CI 1. 025-1. 059; P < 0. 001), nighttime mean SBP (OR 1. 034, 95％ CI 1. 019-1. 049; P < 0. 001), and coefficient of variation of daytime SBP (OR 1. 129, 95％ CI 1. 052-1. 210; P = 0. 003) were independently correlated with the total CSVD score. Conclusions The elevated 24 h, daytime and nighttime mean SBP levels and coefficient of variation of daytime SBP are independently correlated with the severity of overall CSVD burden in patients with acute ischemic stroke.
ABSTRACT
Objective To investigate the correlation between 24-h ambulatory blood pressure (BP) variability and cerebral microbleeds (CMBs) in patients with acute ischemic stroke. Methods Consecutive inpatients with acute ischemic stroke were prospectively enrolled. 24-h ambulatory BP was monitored. Magnetic susceptibility-weighted imaging was used to evaluate CMBs and their locations. Univariate analysis was used to compare the baseline data between the CMBs group and the non-CMBs group. Multivariate logistic regression analysis was used to determine the independent correlation between ambulatory BP related indexes and CMBs. Results A total of 178 patients with acute ischemic stroke were enrolled, including 114 males, aged 67.6 ±10.8 years, and 90 (50.6%) with CMBs. The proportion of hypertension and asymptomatic lacunar infarction, periventricular and deep white matter high signal score, 24-h, daytime, nighttime mean systolic and diastolic BP, 24-h, and daytime systolic BP variability in the CMBs group were significantly higher than those in the non-CMB group (all P<0.05). Multivariate logistic regression analysis showed that 24-h systolic BP variability (odds ratio 1.133, 95% confidence interval 1.023-1.255; P=0.016) and daytime mean systolic BP (odds ratio 1.045, 95% confidence interval 1.022-1.069; P<0.001) had significant independent correlation with CMBs. Conclusion 24-h systolic BP variability and daytime mean systolic BP were the independent risk factors for CMBs in patients with acute ischemic stroke.