title: Plasma fibrinogen, ambulatory blood pressure, and silent cerebrovascular lesions: the Ohasama study.
abstract: 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.
authors.affiliation: Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, 980-8574, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Aono
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.forename: Takeo
authors.initials: T
authors.lastname: Kondo
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Shintani
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Satoh
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Izumi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: 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
chemical_list: D005340:Fibrinogen