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KMID : 0648320100160040030
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Journal of The Korean Society of Hypertension
2010 Volume.16 No. 4 p.30 ~ p.37
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Cerebral Microbleeds are Associated with Nocturnal Hypertension in Hypertensive Stroke Patients
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Lim Jae-Sung
Moon Jang-Sup
Park Hye-Ri
Kwon Hyung-Min
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Abstract
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Background : Ambulatory blood pressure (BP) monitoring is well known for its various parameters which related with cardiovascular diseases. Cerebral microbleeds (CMBs) were observed frequently in patients with hypertension and known as a risk factor for cerebral hemorrhage. However, there are scanty reports about the relationship between ambulatory BP and CMBs.
Methods : We recruited consecutive patients with ischemic stroke except cardioembolism within 7 days after symptom onset. A total of 53 patients (37 males, age 64.0±9.0 years) were included and 24-hour ambulatory BP monitoring was applied two weeks after stroke onset with brain MRI to detect CMBs. The various BP parameters such as mean 24-hour BP, awake, sleep BP, and morning surge were analyzed by logistic regression to figure out the association with CMBs. Subjects were further classified according to nocturnal dipping status and analyzed with adjustment for age, gender and cardiovascular risk factors.
Results : CMBs were detected in 26 patients (49.1%). Nocturnal diastolic BP was independently associated with CMBs (OR 2.63; 95% CI, 1.26-5.50; P=0.01). Revere dippers showed higher prevalence of CMBs than dippers (OR 6.67; 95% CI, 1.32-33.69; P=0.022). CMBs were not associated with morning surge.
Conclusions: CMBs were independently associated with increased nocturnal diastolic BP and reverse dipping on ambulatory BP monitoring.
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KEYWORD
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Ambulatory Blood Pressure Monitoring, Cerebral microbleeds, Target-organ Damage, Hypertension, Blood Pressure
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