Abnormal blood pressure circadian rhythms, specifically the reverse-dipper pattern, were identified as independent risk factors for acute cerebral infarction (HR 3.50) compared to a normal dipper pattern.
Case-Control (n=1,267)
Yes
Do abnormal blood pressure circadian rhythms increase the risk of cerebral infarction and severe leukoaraiosis in hypertensive patients?
Abnormal blood pressure circadian rhythms, particularly reverse-dipper and non-dipper patterns, are independent risk factors for acute cerebral infarction and severe leukoaraiosis in hypertensive patients.
Hazard Ratio: 3.5 (95% CI 2.1–5.9)
p-value: p=<0.001
BACKGROUND: To investigate the relationships between blood pressure (BP) circadian rhythms and acute cerebral infarction (ACI), silent cerebral infarction (SCI) and the severity of leukoaraiosis in hypertensive patients. METHODS: A retrospective case-control study was performed among hypertensive patients with 24-h ambulatory blood pressure monitoring (ABPM) and cranial magnetic resonance imaging (MRI). RESULTS: A total of 1267 patients were enrolled. Lower nocturnal blood pressure (BP) decreases were observed in ACI patients than in controls (3.3% vs 8.2%, P<0.001). Reverse-dipper pattern (RD) and non-dipper pattern (ND) were found to be independent risk factors for ACI. In ACI patients, both RD and ND BP circadian rhythms were revealed to be independent risk factors for moderate-severe leukoaraiosis. In addition, in SCI patients, RD (OR = 1.7, 95% CI, 0.9-3.0; P = 0.047) or extreme-dipper pattern (ED) (OR = 2.9, 95% CI, 1.2-7.0; P = 0.015) were found to be independent risk factors for moderate-severe leukoaraiosis. Moreover, the greater the severity of leukoaraiosis was, the higher the ratio of abnormal BP circadian rhythms. CONCLUSION: RD and ND BP circadian rhythms might not only be relevant to the onset of ACI but also correlate with the severity of leukoaraiosis. Thus, when modulating BP with antihypertensive drugs, the BP circadian rhythms, and not merely the BP level, should warrant more attention.
Yang et al. (Tue,) conducted a case-control in Hypertension with acute cerebral infarction, silent cerebral infarction, or normal MRI (n=1,267). Abnormal blood pressure circadian rhythms (reverse-dipper pattern) vs. Normal blood pressure circadian rhythm (dipper pattern) was evaluated on Acute cerebral infarction (HR 3.50, 95% CI 2.1-5.9, p=<0.001). Abnormal blood pressure circadian rhythms, specifically the reverse-dipper pattern, were identified as independent risk factors for acute cerebral infarction (HR 3.50) compared to a normal dipper pattern.