Association of circadian rhythm of blood pressure and cerebral small vessel disease in community-based elderly population

Hua Zhang, Yi Cui, Yingxin Zhao, Yuanli Dong, Juan Wang, Dandan Duan, Tiantian Ji, Tingting Zhou, Wenjing Hu, Yali Chen, Shangwen Sun, Gary Gong, Qiang Chai, Zhendong Liu

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Although it is accepted that the etiology of cerebral small vessel disease (CSVD) is associated with cardiovascular risk factors, the association between CSVD and the circadian rhythm of blood pressure (BP) is unclear. We aimed to determine if such an association existed in the elderly population. Method: White matter hyperintensities (WMHs), lacunes, microbleeds, nocturnal dipping pattern (NDP), and morning surge in systolic blood pressure (SBP) were assessed in 2,091 participants ≥60 years of age. Results: During an average of 63 months of follow-up, WMH and the WMH-to-intracranial volume ratio were significantly increased in extreme dippers, nondippers, and reverse dippers than those in dippers (p <. 001). For new-incident Fazekas scale ≥2, the hazard ratios were 1.77 (95% confidence interval [CI], 1.09-2.86) for extreme dippers, 2.20 (95% CI, 1.48-3.28) for nondippers, and 2.43 (95% CI, 1.59-3.70) for reverse dippers compared with dippers, and 1.04 (95% CI, 0.81-1.35) for higher morning surge compared with lower morning surge. Nondippers and reverse dippers were associated with higher risks of new-incident lacunes and microbleeds than dippers (p <. 05). Higher morning surge was associated with a higher risk of new-incident microbleeds than lower morning surge (p <. 05). Conclusion: NDPs in SBP played an important role in CSVD, and the morning surge in SBP was associated with cerebral microbleeds in community-based elderly population beyond the average SBP level.

Original languageEnglish (US)
Article numbergly212
Pages (from-to)1322-1330
Number of pages9
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume74
Issue number8
DOIs
StatePublished - Jul 12 2019

Keywords

  • Lacunes
  • Microbleeds
  • Morning surge
  • Nocturnal dipping pattern
  • White matter hyperintensities

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

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