Systemic blood pressure profile in cerebral autosomal dominant arteriopathy with subcortical infarcts and

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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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Alessandra Rufa1, Maria Teresa Dotti, Massimo Franchi

  • 1Dipartimento di Scienze Neurologiche e del Comportamento, Università di Siena, Viale Bracci, 53100 Siena, Italy.

Stroke
|November 12, 2005
PubMed

Insights

Patients with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) exhibit a lower blood pressure (BP) profile, particularly reduced daytime BP. This abnormal BP may contribute to cognitive decline and white matter injury in CADASIL.

Area of Science:

  • Neurology
  • Vascular Biology
  • Genetics

Background:

  • Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a genetic cause of subcortical ischemic vascular dementia.
  • Typical vascular risk factors are often absent in CADASIL.
  • Systemic blood pressure (BP) changes over time in CADASIL are not well-studied, despite BP instability being a risk factor for white matter changes in sporadic SIVD.

Purpose of the Study:

  • To investigate the 24-hour ambulatory blood pressure (BP) profile in CADASIL patients.
  • To explore the relationship between BP variations, cognitive decline, and white matter injury in CADASIL.

Main Methods:

  • 24-hour ambulatory BP monitoring in 14 CADASIL patients and 15 healthy controls.
  • Comparison of daytime and nighttime BP variables (systolic, diastolic, mean arterial BP) and nocturnal BP decline.
  • Assessment of cognitive function using the Mini-Mental State Examination (MMSE) and white matter injury via MRI-derived T2-weighted lesion volume (LV) in CADASIL patients.

Main Results:

  • CADASIL patients demonstrated significantly reduced mean daytime systolic, diastolic, and mean arterial BP compared to controls.
  • A significant reduction in the nocturnal percentage decline of mean arterial BP was observed in CADASIL patients.
  • Cognitive performance (MMSE) in CADASIL patients significantly correlated with daytime mean arterial BP.

Conclusions:

  • CADASIL patients exhibit a distinct low systemic BP profile, characterized by reduced diurnal BP values.
  • This abnormal BP pattern may negatively impact cerebral hemodynamics, potentially increasing the risk of cognitive impairment.
  • The underlying mechanisms for the abnormal BP profile in CADASIL require further investigation, likely involving central and peripheral BP regulatory systems.
Abstract

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