Key result
A review of vascular risk factors indicates that 24-hour ambulatory blood pressure is a strong indicator of white matter hyperintensity progression and functional decline in older persons.
Why the study?
Does 24-hour ambulatory blood pressure-guided antihypertensive therapy better prevent the progression of white matter hyperintensity lesions and functional decline in older persons compared to office blood pressure?
Does 24-hour ambulatory blood pressure-guided antihypertensive therapy better prevent the progression of white matter hyperintensity lesions and functional decline in older persons compared to office blood pressure?
24-hour ambulatory blood pressure monitoring is superior to office blood pressure in predicting the progression of white matter disease and functional decline in older adults, prompting the design of the INFINITY trial.
Supports ambulatory BP monitoring for risk stratification in older adults; leaves open whether ABPM-guided therapy reduces white matter hyperintensity progression.
Several potential vascular risk factors exist for the development and accumulation of subcortical white matter disease in older people. We have reported that in older people followed for up to 4 years white matter hyperintensity (WMH) lesions on magnetic resonance imaging nearly doubled in volume and were associated with alterations in mobility and cognitive function. Herein we review the genetic, metabolic, and vascular risk factors that have been evaluated in association with the development and pathogenesis of WMH in older persons. Our research efforts have focused on systemic hypertension, particularly in the out-of-office setting as 24-hour ambulatory blood pressure (BP) has proven to be a stronger indicator of the progression of WMH in older people and the associated functional decline than doctor’s office BP. Based on relations between 24-hour systolic BP levels, the accrual of WMH, and functional decline, we have designed the INFINITY trial, the first interventional study to use ambulatory BP to guide antihypertensive therapy to address this problem in the geriatric population.
No takes yet. Share an insight, caveat, or question.
Abraham et al. (2015) conducted a review in Subcortical white matter disease. 24-hour ambulatory blood pressure was evaluated. A review of vascular risk factors indicates that 24-hour ambulatory blood pressure is a strong indicator of white matter hyperintensity progression and functional decline in older persons.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: