Blood Pressure Components and Changes in Relation to White Matter Lesions A 32-Year Prospective Population Study
Blood Pressure Components and Changes in Relation to White Matter Lesions A 32-Year Prospective Population Study
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DOI：
10.1161/hypertensionaha.109.129700
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发表时间：
2009-07-01
期刊：
影响因子：
8.3
通讯作者：
Skoog, Ingmar
中科院分区：
文献类型：
--
作者：
Guo, Xinxin;Pantoni, Leonardo;Skoog, Ingmar
本研究旨在检查高血压（收缩压、舒张压、脉压和平均动脉压）对白色病变的长期影响，并研究与白色病变相关的不同血压成分的变化。1968年对妇女的代表性人口进行了调查，并于1974年、1980年、1992年和2000年进行了重新调查。在1992年和2000年对539名妇女进行了计算机断层扫描上的白色病变的存在和严重程度的视觉评定。在所有检查中测量收缩压和舒张压。我们发现1992/2000年白色病变的存在和严重程度与每次检查时较高的舒张压和平均动脉压相关，但与收缩压和脉压无关。舒张压每升高10 mm Hg，出现白色病变的比值比（95%CI）在1968年为1.4（1.0 ~ 1.9），1974年为1.3（1.0 ~ 1.8），1980年为1.4（1.1 ~ 1.9），1992年调整混杂因素后为1.3（1.0 ~ 1.6）。白色病变的存在也与24年舒张压升高有关（>10 mm Hg），收缩压（>40 mm Hg），脉压（>24 mm Hg）和平均动脉压（>6 mm Hg;比值比[95% CI]：舒张压2.6 [1.3 - 5.1];收缩压2.0 [1.2 - 3.4];脉压1.8 [1.1 - 2.7];平均动脉压为2.2 [1.4至3.4]）。我们的研究结果表明，降低高舒张压和防止收缩压和舒张压的大幅增加可能对白色病变具有保护作用。（高血压。2009; 54：57-62.）
This study aimed to examine the long-term effect of high blood pressure (systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure) on white matter lesions and to study changes in different blood pressure components in relation to white matter lesions. A representative population of women was examined in 1968 and re-examined in 1974, 1980, 1992, and 2000. The presence and severity of white matter lesions on computed tomography were rated by a visual rating scale in 1992 and 2000 in 539 women. Systolic and diastolic blood pressures were measured at all of the examinations. We found that presence and severity of white matter lesions in 1992/2000 were associated with higher diastolic blood pressure and mean arterial pressure at each examination but not with systolic blood pressure and pulse pressure. Odds ratios (95% CIs) for the presence of white matter lesions per 10-mm Hg increase in diastolic pressure were 1.4 (1.0 to 1.9) in 1968, 1.3 (1.0 to 1.8) in 1974, 1.4 (1.1 to 1.9) in 1980, and 1.3 (1.0 to 1.6) in 1992 after adjustment for confounders. The presence of white matter lesions was also associated with a 24-year increase in diastolic pressure (>10 mm Hg), systolic pressure (>40 mm Hg), pulse pressure (>24 mm Hg), and mean arterial pressure (>6 mm Hg; odds ratios [95% CIs]: 2.6 [1.3 to 5.1] for diastolic pressure; 2.0 [1.2 to 3.4] for systolic pressure; 1.8 [1.1 to 2.7] for pulse pressure; and 2.2 [1.4 to 3.4] for mean arterial pressure). Our findings suggest that lowering high diastolic blood pressure and preventing large increases in systolic and diastolic blood pressures may have a protective effect on white matter lesions. (Hypertension. 2009; 54: 57-62.)