Résumé
BACKGROUND: Periventricular white matter changes(PVWC) in chronic cerebrovascular disease are regarded to be caused by chronic low perfusion and as forms of small arterial disease of cerebral circulation. In some reports, these are suggested to be concerned with the fluctuation of blood pressure. The purpose of this study was to elucidate the diurnal pattern of BP in chronic cerebrovascular disease and the relationship between severity of PVWC and decrement of nocturnal dip through the ambulatory 24 hour blood pressure monitoring (ABPM). Subjects and METHODS: ABPM were carried out every 30 minutes in 36 patients with chronic cerebrovascular disease, prospectively. Twenty-five had PVWCS and/or multiple lacunar infarction (MLI) with various grades, 11 had large artery territorial infarction (LATI) without PVWC. The patterns of ABPM in each group were analyzed by disease entity and severity of PVWC. RESULTS: There was no differences in the two groups; PVWC/MLl and LATI, in properties(age, sex, etc.) and possible stroke risk factors (hypertension, diabetes mellitus, hypercholesterolemia, smoking, etc.) (P<.05). The pattern of ABPM of PVWC/MLl group showed the decrement of nocturnal dip of BP unlike LATI group (P<.05). The decrement of nocturnal dip of BP correlated with severity of PVWC (P<.05). CONCLUSION: We conclude that the diurnal pattern of BP in small artery disease is different from that of large arterial disease group and related to the severity of PVWC.