title: Impact of night-time blood pressure on cerebral white matter hyperintensity in elderly hypertensive patients.
abstract: OBJECTIVE
  Cerebral white matter hyperintensity (WMH) is highly prevalent in the elderly population, and increases the risk of dementia and stroke. We investigated the relationship between ambulatory blood pressure monitoring levels and quantitatively measured WMH volumes among elderly hypertensive patients with well-controlled blood pressure (BP) to re-evaluated effective hypertension management methods to prevent the progression of WMH.
  
  
  METHODS
  Participants comprised 84 hypertensive patients aged between 65 and 75 years without symptomatic heart failure, ischemic heart disease, atrial fibrillation, stroke or cognitive dysfunction.
  
  
  RESULTS
  Linear regression analysis showed that office BP was not associated with WMH volume increases. Raised night-time systolic BP (P = 0.013) were associated with greater WMH volumes during ambulatory blood pressure monitoring. To clarify the effect of asleep systolic BP on WML volume, we then classified patients into two systolic BP groups as follows: <125 mmHg (n = 47) and ≥125 mmHg (n = 37). Baseline characteristics were almost similar in both groups, except the dipper type of circadian BP variation was significantly common in the group with night-time systolic BP <125 mmHg. However, WMH volume was greater in the group with night-time systolic BP ≥125 mmHg than that in the <125 mmHg group (9.0 ± 8.4 mL vs 4.1 ± 4.3 mL, P = 0.015).
  
  
  CONCLUSIONS
  Higher night-time systolic BP levels were observed to contribute greater WMH volumes in elderly hypertensive patients. To prevent the progression of WMH, controlling BP on the basis of ambulatory blood pressure monitoring is important.
authors.affiliation: Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Cardiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kokubo
authors.affiliation: Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Cardiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Shimizu
authors.affiliation: Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Cardiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Toko
authors.initials: T
authors.lastname: Mitsui
authors.affiliation: Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Cardiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Miyagi
authors.affiliation: Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Cardiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Nomoto
authors.affiliation: Department of Cardiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.affiliation: Department of Gerontology, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Toba
authors.affiliation: Department of Gerontology, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007564:Japan; D049292:Leukoaraiosis / Q000209:etiology / Q000473:pathology; D016014:Linear Models; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D066127:White Matter / Q000473:pathology*
chemical_list: D000959:Antihypertensive Agents
keywords: ambulatory blood pressure monitoring; cerebral white matter hyperintensity; circadian blood pressure variation; night-time blood pressure; office blood pressure