Key result
Higher systolic BP across office, home, or ambulatory monitoring links comparably to asymptomatic ICAS.
Why the study?
Few studies have compared the strength of the relationship between strictly measured office and out-of-office blood pressure measurements, and the relationship of day-by-day or short-term BP variability to asymptomatic intracranial artery stenosis remains unclear.
Are strictly measured office, home, and ambulatory blood pressures associated with asymptomatic intracranial artery stenosis in apparently healthy older men?
Cross-Sectional (n=677)
No
Are strictly measured office, home, and ambulatory blood pressures associated with asymptomatic intracranial artery stenosis in apparently healthy older men?
Strictly measured office blood pressure is as strongly associated with asymptomatic intracranial artery stenosis as home or ambulatory blood pressure monitoring, while circadian variations like morning surge also correlate with disease burden.
Answers are grounded in this paper and cite their sources.
Office SBP may suffice for ICAS risk assessment in older men; leaves open whether home or ambulatory monitoring improves stratification or outcomes.
OBJECTIVE: Hypertension and intracranial artery stenosis (ICAS) are closely related; however, few studies have compared the strength of the relationship between strictly measured office and out-of-office blood pressure (BP) measurements. The relationship of day-by-day or short-term variability in BP to asymptomatic ICAS also remains unclear. METHODS: In apparently healthy 677 men (mean age, 70 years) from a population-based cohort, we examined the association of strictly measured office BP and 7-day home BP with ICAS on magnetic resonance angiography. We conducted 24-h ambulatory BP monitoring in 468 of the men. Variability indices included day-by-day, daytime, and night-time variability, nocturnal decline, and morning pressor surge. Any ICAS was defined as either mild (1-49%) or severe (≥50%) stenosis. RESULTS: We observed mild and severe ICAS in 153 (22.6%) and 36 (5.3%) participants, respectively. In multivariable-adjusted Poisson regression with robust error variance, higher SBP in office, home, or ambulatory BP monitoring was associated with the presence of any or severe ICAS. The associations with ICAS were comparable between office, home, and ambulatory SBP (all heterogeneity P values >0.1). Independent of mean SBP, greater nocturnal decline or morning pressor surge, but not day-by-day, daytime, or night-time variability, in SBP was associated with higher burden of any or severe ICAS. CONCLUSION: The magnitude of association of strictly measured office BP for asymptomatic ICAS was comparable with that of BP measured at home or in ambulatory BP monitoring. Circadian BP variation based on ambulatory BP monitoring was positively associated with asymptomatic ICAS burden.
No takes yet. Share an insight, caveat, or question.
Hisamatsu et al. (2021) conducted a cross-sectional in Asymptomatic intracranial arterial stenosis (n=677). Elevated systolic blood pressure (office, home, or ambulatory) vs. Lower systolic blood pressure was evaluated on Presence of any or severe intracranial arterial stenosis (ICAS) on magnetic resonance angiography. Higher systolic blood pressure, whether strictly measured in the office, at home, or via ambulatory monitoring, was comparably associated with the presence of asymptomatic intracranial arterial stenosis.
Synapse has enriched 10 related papers. Consider them for comparative context: