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

Research output: Contribution to journalArticle

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

Fingerprint

Intracranial Arteriosclerosis
Blood Pressure
Growth
Hypertension
Stroke
Odds Ratio
Confidence Intervals
Office Visits
House Calls
White Matter
Pathologic Constriction

Keywords

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

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Kim, B. J., Kwon, S. U., Park, J. M., Hwang, Y. H., Heo, S. H., Rha, J. H., ... 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

Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis. / Kim, Bum Joon; Kwon, Sun U.; Park, Jong Moo; Hwang, Yang Ha; Heo, Sung Hyuk; Rha, Joung Ho; Lee, Jun; Park, Man Seok; Kim, Joon Tae; Song, Hee Jung; Park, Jong Ho; Yu, Sungwook; Lee, Soo Joo; Park, Tai Hwan; Cha, Jae Kwan; Kwon, Hyung Min; Kim, Eung Gyu; Lee, Seung Hoon; Lee, Ji Sung; Lee, Juneyoung; Kang, Dong Wha.

In: American journal of hypertension, Vol. 32, No. 9, 14.08.2019, p. 918-924.

Research output: Contribution to journalArticle

Kim, BJ, Kwon, SU, Park, JM, Hwang, YH, Heo, SH, Rha, JH, Lee, J, Park, MS, Kim, JT, Song, HJ, Park, JH, Yu, S, Lee, SJ, Park, TH, Cha, JK, Kwon, HM, Kim, EG, Lee, SH, Lee, JS, Lee, J & Kang, DW 2019, 'Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis', American journal of hypertension, vol. 32, no. 9, pp. 918-924. https://doi.org/10.1093/ajh/hpz068
Kim, Bum Joon ; Kwon, Sun U. ; Park, Jong Moo ; Hwang, Yang Ha ; Heo, Sung Hyuk ; Rha, Joung Ho ; Lee, Jun ; Park, Man Seok ; Kim, Joon Tae ; Song, Hee Jung ; Park, Jong Ho ; Yu, Sungwook ; Lee, Soo Joo ; Park, Tai Hwan ; Cha, Jae Kwan ; Kwon, Hyung Min ; Kim, Eung Gyu ; Lee, Seung Hoon ; Lee, Ji Sung ; Lee, Juneyoung ; Kang, Dong Wha. / Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis. In: American journal of hypertension. 2019 ; Vol. 32, No. 9. pp. 918-924.
@article{9b095bbe18fd43ac87dee8dcb6df42de,
title = "Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis",
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.",
keywords = "blood pressure, blood pressure variability, hypertension, intracranial atherosclerosis, white matter lesion",
author = "Kim, {Bum Joon} and Kwon, {Sun U.} and Park, {Jong Moo} and Hwang, {Yang Ha} and Heo, {Sung Hyuk} and Rha, {Joung Ho} and Jun Lee and Park, {Man Seok} and Kim, {Joon Tae} and Song, {Hee Jung} and Park, {Jong Ho} and Sungwook Yu and Lee, {Soo Joo} and Park, {Tai Hwan} and Cha, {Jae Kwan} and Kwon, {Hyung Min} and Kim, {Eung Gyu} and Lee, {Seung Hoon} and Lee, {Ji Sung} and Juneyoung Lee and Kang, {Dong Wha}",
year = "2019",
month = "8",
day = "14",
doi = "10.1093/ajh/hpz068",
language = "English",
volume = "32",
pages = "918--924",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis

AU - Kim, Bum Joon

AU - Kwon, Sun U.

AU - Park, Jong Moo

AU - Hwang, Yang Ha

AU - Heo, Sung Hyuk

AU - Rha, Joung Ho

AU - Lee, Jun

AU - Park, Man Seok

AU - Kim, Joon Tae

AU - Song, Hee Jung

AU - Park, Jong Ho

AU - Yu, Sungwook

AU - Lee, Soo Joo

AU - Park, Tai Hwan

AU - Cha, Jae Kwan

AU - Kwon, Hyung Min

AU - Kim, Eung Gyu

AU - Lee, Seung Hoon

AU - Lee, Ji Sung

AU - Lee, Juneyoung

AU - Kang, Dong Wha

PY - 2019/8/14

Y1 - 2019/8/14

N2 - 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.

AB - 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.

KW - blood pressure

KW - blood pressure variability

KW - hypertension

KW - intracranial atherosclerosis

KW - white matter lesion

UR - http://www.scopus.com/inward/record.url?scp=85071349460&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071349460&partnerID=8YFLogxK

U2 - 10.1093/ajh/hpz068

DO - 10.1093/ajh/hpz068

M3 - Article

C2 - 31044227

AN - SCOPUS:85071349460

VL - 32

SP - 918

EP - 924

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 9

ER -