J Clin Neurol.  2009 Sep;5(3):139-145. 10.3988/jcn.2009.5.3.139.

Relationships between 24-Hour Blood Pressures, Subcortical Ischemic Lesions, and Cognitive Impairment

Affiliations
  • 1Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea. jjeong@ewha.ac.kr
  • 2Department of Neurology, Seoul National University College of Medicine Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
The most important treatment for subcortical vascular dementia (SVaD) is controlling the blood pressure (BP). However, the few studies that have investigated the relationships between diurnal BP rhythm and subcortical ischemic vascular cognitive impairment have produced inconclusive results. In the study presented here, the 24-hour BP values of three groups of subjects-patients with subcortical vascular mild cognitive impairment (SvMCI), patients with SVaD, and normal controls-were compared using working criteria and 24-hour ambulatory BP (ABP) monitoring. METHODS: The subjects (42 patients with SVaD, 37 patients with SvMCI, and 30 controls) were selected according to the study's inclusion/exclusion criteria. All subjects underwent brain magnetic resonance (MR) imaging and MR angiography, detailed neuropsychological testing, and 24-hour ABP monitoring. RESULTS: The prevalence of nondippers differed markedly between the control group and both the SVaD and SvMCI groups. Loss of nocturnal dipping was significantly associated with SVaD [odds ratio (OR), 4.827; 95% confidence interval (CI), 1.07-12.05]. CONCLUSIONS: It was found that SVaD is associated with loss of nocturnal BP dipping combined with increased pulse pressure and systolic BP (SBP) variability. Correction of these factors could therefore be important in the prevention of SVaD, independent of measures used to reduce BP.

Keyword

24-hour blood pressure values; subcortical vascular mild cognitive impairment; subcortical vascular dementia

MeSH Terms

Angiography
Blood Pressure
Brain
Dementia, Vascular
Humans
Magnetic Resonance Spectroscopy
Mild Cognitive Impairment
Neuropsychological Tests
Prevalence

Reference

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