Relationship between morning blood pressure variability and cerebral microbleed burden in patients with hypertension

Area of Science:

• Neurology
• Cardiology
• Hypertension Research

Background:

• Cerebral microbleeds (CMBs) represent a significant form of target organ damage in patients with hypertension.
• Understanding the relationship between CMB burden and blood pressure (BP) variability is crucial for managing hypertension complications.

Purpose of the Study:

• To investigate the association between the number of cerebral microbleeds (CMBs) and morning blood pressure (BP) variability in hypertensive individuals.
• To differentiate the impact of CMB burden on both overall and non-lobar CMBs concerning BP variability.

Main Methods:

• Recruited 791 hypertensive patients, categorized by CMB count (1-10 vs. >10).
• Collected data on hypertension duration, grade, medication, and control.
• Monitored morning home BP measurements every 3 days for one month, analyzing variability using standard deviation (SD) and coefficient of variation (CV).

Main Results:

• Higher morning home diastolic BP variability (SD and CV) was significantly associated with a higher CMB burden (>10 CMBs).
• Patients with >10 non-lobar CMBs exhibited significantly higher morning systolic and diastolic BP variability (SD, CV, average real variability) compared to those with 1-10 non-lobar CMBs.
• Multivariate analysis confirmed that increased morning home diastolic BP variability (SD, CV) correlated with more than 10 non-lobar CMBs.

Conclusions:

• Elevated morning diastolic blood pressure variability is a significant predictor of increased CMB burden, including non-lobar microbleeds.
• Morning BP variability, especially diastolic, should be considered a critical factor in assessing hypertension-related cerebral damage.