title: Pulse Pressure and Cognitive Decline in Stroke Patients With White Matter Changes.
abstract: The authors hypothesized that both high and low pulse pressure (PP) may predict cognitive decline in stroke/transient ischemic attack (TIA) patients with white matter changes (WMCs). The authors prospectively followed up 406 ischemic stroke/TIA patients with confluent WMCs over 18 months. PP was measured at 3 to 6 months after stroke/TIA and categorized into four groups by quartile. Cognition was assessed 3 to 6 months and 15 to 18 months after stroke/TIA using the Clinical Dementia Rating and Mini-Mental State Examination (MMSE). Logistic regression showed that patients in the first quartile of PP had a 5.9-fold higher risk for developing cognitive decline than patients in the third quartile (odds ratio, 5.9; 95% confidence interval, 1.7-20.6), while patients in the fourth quartile had a 3.5-fold higher risk for cognitive decline than those in the third quartile (odds ratio, 3.5; 95% confidence interval, 1.0-12.4). This U-shaped relationship was also evident between PP and cognitive decline in MMSE, underlining the role of arterial stiffness and hypoperfusion in cognitive decline related to small vessel disease.
authors.affiliation: Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Zhaolu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.affiliation: Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Wenyan
authors.initials: W
authors.lastname: Liu
authors.affiliation: Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Imaging and Interventional Radiology, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Winnie C W
authors.initials: WC
authors.lastname: Chu
authors.affiliation: Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Lisa
authors.initials: L
authors.lastname: Au
authors.affiliation: Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lau
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Vincent C T
authors.initials: VC
authors.lastname: Mok
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003704:Dementia / Q000209:etiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D020521:Stroke / Q000473:pathology* / Q000523:psychology; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*