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Relationship of Four Blood Pressure Indexes to Subclinical Cerebrovascular Diseases Assessed by Brain MRI in General
Ebtehal Salman1,2, Aya Kadota1,2, Takashi Hisamatsu3
1Department of Public Health, Shiga University of Medical Science.
Insights
Blood pressure indexes are linked to subclinical cerebrovascular diseases in Japanese men. Different blood pressure measurements over time correlate with various cerebrovascular conditions detected by MRI.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Subclinical cerebrovascular diseases (SCVDs) are linked to increased stroke risk.
- The precise relationship between various blood pressure (BP) indexes and SCVDs requires further clarification.
Purpose of the Study:
- To investigate the association between four BP indexes (systolic, diastolic, pulse pressure, mean arterial pressure) and prevalent SCVDs in Japanese men.
- To examine how BP measurements taken at two different time points relate to SCVDs assessed via MRI.
Main Methods:
- A cohort of 616 Japanese men aged 40-79 years had BP measured at two visits.
- MRI scans assessed SCVDs including lacunar infarction, white matter hyperintensities, microbleeds, and intracranial artery stenosis.
- Multivariable logistic regression analyzed the odds of SCVDs for higher BP indexes, using both office and home BP measurements.
Main Results:
- All four office BP indexes were associated with lacunar infarction.
- Diastolic BP and Mean Arterial Pressure at Visit 1, and Diastolic BP at Visit 2, were linked to periventricular and deep subcortical white matter hyperintensities.
- Visit 2 BP indexes showed a stronger association with microbleeds, while systolic BP, pulse pressure, and mean arterial pressure at both visits correlated with intracranial artery stenosis.
Conclusions:
- Blood pressure indexes are associated with most SCVDs in general Japanese men.
- BP measurements taken at different time points reveal distinct associations with specific SCVDs identified by MRI.
Aim:
The relationship of blood pressure (BP) indexes (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], mean arterial pressure [MAP]) to subclinical cerebrovascular diseases (SCVDs) remains unclear. This study aimed to elucidate the relationship of four BP indexes measured at two visits on SCVDs assessed by magnetic resonance imaging (MRI) in general Japanese men.
Methods:
In general Japanese men aged 40-79 years (N=616), office BP indexes were measured at two visits (Visits 1 [2006-2008] and 2 [2010-2014]). MRI images obtained on the third visit (2012-2015) were examined for prevalent SCVDs: lacunar infarction, periventricular hyperintensity (PVH), deep subcortical white matter hyperintensity (DSWMH), microbleeds, and intracranial artery stenosis (ICAS). Using a multivariable logistic regression analysis, we computed and estimated the odds ratio of each prevalent SCVD for one standard deviation higher BP indexes. The same analyses were performed using home BP.
Results:
All four office BP indexes at both visits associated with lacunar infarction. Visit 1 and 2 DBP and Visit 1 MAP associated with PVH and DSWMH, and Visit 1 SBP associated with DSWMH. All Visit 2 BP indexes appear to show stronger association with microbleeds than Visit 1 indexes, and Visit 1 and 2 SBP, PP, and MAP showed similar associations with ICAS. Additional analyses using home BP indexes revealed similar relationships; however, the significance of some relationships decreased.
Conclusion:
In general Japanese men, BP indexes were associated with most of SCVDs, and BP indexes measured at different periods associated with different SCVDs assessed by MRI.
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Prepare for the Procedure:
01:28Factors affecting Blood pressure
Physiological Factors:
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.