Long-term blood pressure variability and cerebrovascular changes on CT in a community-based elderly population.
The effects of long-term blood pressure (BP) levels on cerebrovascular changes were analyzed in a community-based healthy elderly population. Cranial computed tomography (CT) was performed for 300 residents aged 69 years and older. Long-term BP during the ten years prior to CT was assessed, and the cerebrovascular changes were compared among different patterns of long-term blood pressure variability. White matter lesions (WML) and/or silent infarctions (SI) were found in 73 subjects (23.6%). Multiple logistic regression analysis showed that subjects with long-term diastolic hypertension (DHT) had the highest risk of cerebrovascular changes (adjusted odds ratio (OR), 95% confidence interval (CI); 7.1, 2.4-21.6, for WML; 7.2, 2.7-19.4, for SI), and that long-term isolated systolic hypertension (ISHT) was significantly associated with SI (adjusted OR, 95%CI, 2.3, 1.1-4.9), but not with WML (adjusted OR, 95%CI, 1.3, 0.5-3.3). Efforts to prevent both DHT and ISHT would be beneficial, though different underlying mechanisms for WML and SI were suggested.
Tsukishima
E
E
Department of Public Health, Hokkaido University Graduate School of Medicine, Japan.
Saito
H
H
Shido
K
K
Kobashi
G
G
Ying-Yan
G
G
Kishi
R
R
Niino
M
M
Kondo
K
K
Sugimura
I
I
D000368:Aged; D001794:Blood Pressure; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D004522:Educational Status; D005260:Female; D005853:Geriatrics; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D014057:Tomography, X-Ray Computed