Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement: the Ohasama study.
Objective To investigate the risk of silent cerebrovascular lesions in individuals with masked hypertension (MHT) and white-coat hypertension. Methods Self-measured home blood pressure (HBP) and casual blood pressure (CBP) measurements were recorded in 1060 individuals at least 55 years of age (mean age, 66.3 years) in a general population of Ohasama, Japan. The relationships between silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected on MRI and four blood pressure groups [sustained normal blood pressure (SNBP), HBP <135/85 mmHg, CBP <140/ 90 mmHg; white-coat hypertension, HBP <135/85 mmHg, CBP > or =140/90 mmHg; MHT, HBP > or =135/85 mmHg, CBP <140/90 mmHg; sustained hypertension, HBP > or =135/85 mmHg, CBP > or =140/90 mmHg] were examined using multivariate analysis adjusted for possible confounding factors. Results The odds ratios of sustained hypertension (1.74, 95% confidence interval 1.18-2.57) and MHT (2.31, 95% confidence interval 1.32-4.04) for the presence of silent cerebrovascular lesions were significantly higher than the odds ratio of SNBP, whereas there was no significant difference between white-coat hypertension and SNBP (1.03, 95% confidence interval 0.75-1.41). The odds ratios for the presence of either lacunar infarct or white matter hyperintensity in the four groups were similar to those for silent cerebrovascular lesions. Conclusion The present study is the first to demonstrate that the risk of silent cerebrovascular lesions is higher with MHT than with SNBP and similar to that of sustained hypertension.
Hara
Azusa
A
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
Ohkubo
Takayoshi
T
Kondo
Takeo
T
Kikuya
Masahiro
M
Aono
Yoko
Y
Hanawa
Sugiko
S
Shioda
Kyoko
K
Miyamoto
Sayaka
S
Obara
Taku
T
Metoki
Hirohito
H
Inoue
Ryusuke
R
Asayama
Kei
K
Hirose
Takuo
T
Totsune
Kazuhito
K
Hoshi
Haruhisa
H
Izumi
Shin-Ichi
S
Satoh
Hiroshi
H
Imai
Yutaka
Y
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012648:Self Care / Q000379:methods