title: Relationships between 24-Hour Blood Pressures, Subcortical Ischemic Lesions, and Cognitive Impairment.
abstract: OBJECTIVE
  The most important treatment for subcortical vascular dementia (SVaD) is controlling the blood pressure (BP). However, the few studies that have investigated the relationships between diurnal BP rhythm and subcortical ischemic vascular cognitive impairment have produced inconclusive results. In the study presented here, the 24-hour BP values of three groups of subjects-patients with subcortical vascular mild cognitive impairment (SvMCI), patients with SVaD, and normal controls-were compared using working criteria and 24-hour ambulatory BP (ABP) monitoring.
  
  
  METHODS
  The subjects (42 patients with SVaD, 37 patients with SvMCI, and 30 controls) were selected according to the study's inclusion/exclusion criteria. All subjects underwent brain magnetic resonance (MR) imaging and MR angiography, detailed neuropsychological testing, and 24-hour ABP monitoring.
  
  
  RESULTS
  The prevalence of nondippers differed markedly between the control group and both the SVaD and SvMCI groups. Loss of nocturnal dipping was significantly associated with SVaD [odds ratio (OR), 4.827; 95% confidence interval (CI), 1.07-12.05].
  
  
  CONCLUSIONS
  It was found that SVaD is associated with loss of nocturnal BP dipping combined with increased pulse pressure and systolic BP (SBP) variability. Correction of these factors could therefore be important in the prevention of SVaD, independent of measures used to reduce BP.
authors.affiliation: Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Shin
authors.forename: Jee Hyang
authors.initials: JH
authors.lastname: Jeong
authors.forename: Kyong Gyu
authors.initials: KG
authors.lastname: Choi
authors.forename: Kee Duk
authors.initials: KD
authors.lastname: Park
authors.forename: Sangyun
authors.initials: S
authors.lastname: Kim