Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis

Bum Joon Kim, Sun U. Kwon, Jong Moo Park, Yang Ha Hwang, Sung Hyuk Heo, Joung Ho Rha, Jun Lee, Man Seok Park, Joon Tae Kim, Hee Jung Song, Jong Ho Park, Sungwook Yu, Soo Joo Lee, Tai Hwan Park, Jae Kwan Cha, Hyung Min Kwon, Eung Gyu Kim, Seung Hoon Lee, Ji Sung Lee, Juneyoung LeeDong Wha Kang

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2 Citations (Scopus)

Abstract

BACKGROUND: High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS). METHODS: This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50% stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs. RESULTS: Of the 111 enrolled patients, 69 patients (67.6%) demonstrated WML growth and 15 patients (13.7%) had NILs. Patients with higher BPV demonstrated a more WML growth (50% vs. 61.8% vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4% vs. 5.4% vs. 29.7%; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95% confidence interval (CI) = 1.005-1.101); P = 0.03] and home BPV [OR = 1.149 (95% CI = 1.013-1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95% CI = 0.874-0.984); P = 0.02] and high home BPV [OR = 1.287 (95% CI = 1.086-1.526); P = 0.004] were independently associated with NILs at follow-up. CONCLUSIONS: High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.

Original languageEnglish
Pages (from-to)918-924
Number of pages7
JournalAmerican journal of hypertension
Volume32
Issue number9
DOIs
Publication statusPublished - 2019 Aug 14

Keywords

  • blood pressure
  • blood pressure variability
  • hypertension
  • intracranial atherosclerosis
  • white matter lesion

ASJC Scopus subject areas

  • Internal Medicine

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  • Cite this

    Kim, B. J., Kwon, S. U., Park, J. M., Hwang, Y. H., Heo, S. H., Rha, J. H., Lee, J., Park, M. S., Kim, J. T., Song, H. J., Park, J. H., Yu, S., Lee, S. J., Park, T. H., Cha, J. K., Kwon, H. M., Kim, E. G., Lee, S. H., Lee, J. S., ... Kang, D. W. (2019). Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis. American journal of hypertension, 32(9), 918-924. https://doi.org/10.1093/ajh/hpz068