Key result
A higher burden of cerebral small vascular disease markers independently predicted major adverse cardiac and cerebrovascular events in patients with hypertension (OR 1.940; 95% CI 1.393-2.703; P<0.001).
Why the study?
The study aimed to test whether a higher burden of cerebral small vascular disease predicts major adverse cardiac and cerebrovascular events in hypertension patients, and whether abnormal blood pressure variability pattern aggravates total CSVD burden.
Does a higher burden of cerebral small vascular disease predict major adverse cardiac and cerebrovascular events in patients with hypertension?
Cohort (n=908)
Yes
Does a higher burden of cerebral small vascular disease predict major adverse cardiac and cerebrovascular events in patients with hypertension?
Odds Ratio: 1.94 (95% CI 1.393–2.703)
p-value: p=<0.001
In patients with hypertension, a higher burden of cerebral small vascular disease independently predicts MACCE and is associated with abnormal blood pressure variability patterns.
CSVD burden and BPV in hypertension need prospective validation; leaves open prediction of MACCE or therapeutic implications.
Background and Objectives The study aims to test the hypotheses that a higher burden of cerebral small vascular disease (CSVD) predicts major adverse cardiac and cerebrovascular events (MACCE) in patients with hypertension (HTN) and that abnormal blood pressure variability (BPV) pattern aggravates total CSVD burden. Methods We retrospectively reviewed patients with HTN prospectively selected between February 2015 and February 2019 from three participating centers. Patients were included if they had HTN for over 1 year and had at least one MRI feature of CSVD. Independent predictors were found using multivariate logistic regression. Results Among the 908 patients who finally enrolled in the study, the number of CSVD markers (OR = 1.940; 95% CI = 1.393–2.703; P < 0.001) independently predicted MACCE with acceptable predictive value (C-statistic = 0.730; 95% CI = 0.669–0.791; P < 0.001). An abnormal BPV pattern was identified as an independent risk factor for increased CSVD burden. Among them, reverse-dipper subtype demonstrated the most significant relationship (OR = 1.725; 95% CI = 1.129–2.633; P = 0.012). Conclusion Total CSVD burden predicts an increased risk of composite MACCE independently. An abnormal BPV pattern is associated with a higher burden of CSVD.
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Xu et al. (2022) conducted a cohort in Hypertension and cerebral small vascular disease (n=908). Higher burden of cerebral small vascular disease (CSVD) vs. Lower burden of CSVD was evaluated on Major adverse cardiac and cerebrovascular events (MACCE) (OR 1.940, 95% CI 1.393-2.703, p=<0.001). A higher burden of cerebral small vascular disease markers independently predicted major adverse cardiac and cerebrovascular events in patients with hypertension (OR 1.940; 95% CI 1.393-2.703; P<0.001).
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