Plasma fibrinogen, ambulatory blood pressure, and silent cerebrovascular lesions: the Ohasama study.
OBJECTIVE
Twenty-four-hour ambulatory blood pressure (24-hour ABP) values are considered a powerful predictor of stroke. Silent cerebrovascular lesions are associated with an increased risk of stroke. Because fibrinogen is a major determinant of plasma viscosity, an elevated fibrinogen level might also be associated with stroke risk. We evaluated the association of 24-hour ABP and plasma fibrinogen levels with the risk of silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected by MRI.


RESULTS
The study cohort comprised 958 individuals from the general population of Ohasama, a rural Japanese community. Multiple logistic regression analysis adjusted for age, sex, smoking and drinking status, use of antihypertensive medication, body mass index, 24-hour ABP, and a history of hypercholesterolemia, diabetes mellitus, and atrial fibrillation demonstrated that each 1-SD increase in fibrinogen level was associated with a significantly increased risk of silent cerebrovascular lesions (odds ratio, 1.26; P=0.001). The 24-hour ABP was also significantly and independently associated with the risk of silent cerebrovascular lesions. Even when 24-hour ABP values were within normal range (<135/80 mm Hg), elevated fibrinogen levels were associated with an increased risk of silent cerebrovascular lesions. Fibrinogen and 24-hour BP had additive effects on silent cerebrovascular lesions.


CONCLUSIONS
The 24-hour ABP and plasma fibrinogen levels were closely and independently associated with the risk of silent cerebrovascular lesions including white matter hyperintensity and lacunar infarct.
Aono
Yoko
Y
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, 980-8574, Japan.
Ohkubo
Takayoshi
T
Kikuya
Masahiro
M
Hara
Azusa
A
Kondo
Takeo
T
Obara
Taku
T
Metoki
Hirohito
H
Inoue
Ryusuke
R
Asayama
Kei
K
Shintani
Yoriko
Y
Hashimoto
Junichiro
J
Totsune
Kazuhito
K
Hoshi
Haruhisa
H
Satoh
Hiroshi
H
Izumi
Shin-ichi
S
Imai
Yutaka
Y
D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002544:Cerebral Infarction / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment
D005340:Fibrinogen