title: Higher ambulatory blood pressure relates to new cerebral microbleeds: 2-year follow-up study in lacunar stroke patients.
abstract: OBJECTIVE
  Elevated blood pressure (BP) is associated with the presence of cerebral microbleeds (CMBs) in cross-sectional studies. However, longitudinal studies did not show a convincing relationship. We aimed to determine the association between elevated BP levels and the occurrence of new CMBs after a 2-year follow-up in first-ever lacunar stroke patients using ambulatory BP monitoring.
  
  
  METHODS
  Ninety-six first-ever lacunar stroke patients underwent brain MRI and ambulatory BP monitoring at baseline and after 2-year follow-up. We used logistic regression analyses to assess the association of BP levels with new CMBs.
  
  
  RESULTS
  We found new CMBs in 17 patients (18%). Higher 24-hour, day and night systolic BP (odds ratio, 2.69; 95% confidence interval, 1.40-5.21 per SD increase for 24-hour BP) and diastolic BP (odds ratio, 2.13; 95% confidence interval, 1.15-3.90 per SD increase for 24-hour BP) at baseline were associated with the development of new CMBs independent of age and sex. BP levels decreased during follow-up in both patients with and without new CMBs. Unlike BP levels at baseline, there was no difference in BP levels at follow-up between patients with and without new CMBs.
  
  
  CONCLUSIONS
  Both higher systolic and diastolic BP levels were associated with the development of new CMBs in a population of lacunar stroke patients. Decrease of BP levels during follow-up did not halt progression of CMBs; however, it remains to be determined whether (early) intervention with antihypertensive drugs can slow down progression of CMBs.
authors: Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands. p.klarenbeek@mumc.nl
authors: Pim
authors: P
authors: Klarenbeek
authors: Robert J
authors: RJ
authors: van Oostenbrugge
authors: Rob P W
authors: RP
authors: Rouhl
authors: Iris L H
authors: IL
authors: Knottnerus
authors: Julie
authors: J
authors: Staals
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002560:Cerebrovascular Circulation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D015588:Observer Variation; D016017:Odds Ratio; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D059409:Stroke, Lacunar / Q000175:diagnosis* / Q000503:physiopathology; D013599:Systole