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KMID : 1100220070060010001
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Dementia and Neurocognitive Disorders
2007 Volume.6 No. 1 p.1 ~ p.6
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The Relationship between 24-Hour Blood Pressure Readings and the Subcortical Ischemic Vascular Cognitive Impairment
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Kim Jung-Eun
Yum Kyu-Sun
Kim Yong-Duk
Na Sang-Jun
Lee Kee-Ook
Yoon Hyun-Ju
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Abstract
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Background: Twenty-four-hour blood pressure (BP) readings have been found to correlate with hypertensive target organ damage. White matter lesions (WML) probably represent manifestations of cerebral hypertensive target organ damage. Recent findings of a linkage between high BP and later development of dementia have given new prospects on cerebral target-organ damage in hypertension. Little has been studied about the differences in the pattern of 24-hour blood pressure readings in the patients with subcortical ischemic vascular cognitive impairment (VCI). We aimed to assess the differences in the pattern of 24-hour blood pressure readings in subcortical ischemic VCI and delineate the relationship between 24-hour BP measurements and cognitive impairment/WML.
Methods: 14 SIVCI patients participated in this study and were examined with 24-hour BP monitoring. All patients were evaluated by the K-MMSE and Brain MRI. WML were subdivided into periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWH).
Results: The patients with subcortical ischemic VCI had significantly greater daytime systolic blood pressure, systolic blood pressure variability, and nondipping status (p<0.05). Among the patients with subcortical ischemic VCI, absence of dipping status was associated with attention and calculation scores (p<0.05) and was significantly associated with PVH and DWH (p<0.05).
Conclusion: Non-dipping and reverse-dipping were relatively common in subcortical ischemic VCI patients. A nondipping status appears to be directly associated with decline of attention and WML. This study indicates the need for further studies to investigate whether or not controlling nighttime BP will help reduce the risk for subcortical ischemic VCI.
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KEYWORD
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24-hour blood pressure monitoring, Subcortical ischemic vascular cognitive impairment, Nondipping status
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