Blood pressure variability and leukoaraiosis amount in cerebral small-vessel disease

Area of Science:

• Neurology
• Cardiology
• Radiology

Background:

• Cerebral small-vessel disease (CSVD) is a common cause of stroke.
• Leukoaraiosis (LA) is a marker of CSVD on MRI.
• Blood pressure (BP) variability is increasingly recognized as a risk factor for cerebrovascular events.

Purpose of the Study:

• To investigate the association between BP variability and the amount of leukoaraiosis in patients with symptomatic CSVD.
• To determine if heightened BP variability correlates with more severe white matter changes.

Main Methods:

• Twenty-five hypertensive patients with symptomatic CSVD (Binswanger's disease or lacunar infarction) were studied.
• Office BP was recorded for 3 weeks, followed by 24-h ambulatory BP monitoring.
• Cerebral MRI was performed to quantify leukoaraiosis using a standardized LA score.

Main Results:

• No significant correlation was found between the LA score and baseline systolic or diastolic BP.
• No significant correlation was observed between the LA score and 24-h, daytime, or nighttime BP levels.
• No significant correlation was found between the LA score and BP variability (systolic or diastolic).

Conclusions:

• Increased blood pressure variability is not associated with greater leukoaraiosis in patients with symptomatic cerebral small-vessel disease.
• These findings suggest that BP variability may not be a direct contributor to the white matter changes seen in this patient population.