Plasma fibrinogen, ambulatory blood pressure, and silent cerebrovascular lesions - The Ohasama study
Plasma fibrinogen, ambulatory blood pressure, and silent cerebrovascular lesions - The Ohasama study
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DOI：
10.1161/01.atv.0000258947.17570.38
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发表时间：
2007-04-01
影响因子：
8.7
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Aono, Yoko;Ohkubo, Takayoshi;Imai, Yutaka
目的：24小时动态血压(24小时ABP)值被认为是中风的有力预测指标。无症状的脑血管病变与中风风险增加有关。由于纤维蛋白原是血浆粘度的主要决定因素，纤维蛋白原水平升高也可能与中风风险有关。我们评估了24小时ABP和血浆纤维蛋白原水平与MRI检测的无症状性脑血管病变(白质高信号和腔隙梗塞)的风险之间的关系。方法和结果-研究队列包括来自日本农村社区大阪的958人。调整了年龄、性别、吸烟和饮酒状况、使用降压药、体重指数、24小时平均动脉压、高胆固醇血症、糖尿病和心房颤动史的多元Logistic回归分析显示，纤维蛋白原水平每增加1-SD与无症状脑血管病变的风险显著增加相关(优势比1.26；P=0.001)。24小时的ABP也与无症状脑血管病变的风险显著且独立相关。即使24小时的ABP值在正常范围内(<；135/80 mm Hg)，纤维蛋白原水平升高也与无症状脑血管病变的风险增加有关。纤维蛋白原和24小时血压对无症状性脑血管病变有相加作用。结论：24小时血压和血浆纤维蛋白原水平与无症状性脑血管病变的风险密切相关，包括白质高信号和腔隙梗死。
Objective - Twenty-four-hour ambulatory blood pressure (24-hour ABP) values are considered a powerful predictor of stroke. Silent cerebrovascular lesions are associated with an increased risk of stroke. Because fibrinogen is a major determinant of plasma viscosity, an elevated fibrinogen level might also be associated with stroke risk. We evaluated the association of 24-hour ABP and plasma fibrinogen levels with the risk of silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected by MRI.Methods and Results - The study cohort comprised 958 individuals from the general population of Ohasama, a rural Japanese community. Multiple logistic regression analysis adjusted for age, sex, smoking and drinking status, use of antihypertensive medication, body mass index, 24-hour ABP, and a history of hypercholesterolemia, diabetes mellitus, and atrial fibrillation demonstrated that each 1-SD increase in fibrinogen level was associated with a significantly increased risk of silent cerebrovascular lesions (odds ratio, 1.26; P=0.001). The 24-hour ABP was also significantly and independently associated with the risk of silent cerebrovascular lesions. Even when 24-hour ABP values were within normal range (< 135/80 mm Hg), elevated fibrinogen levels were associated with an increased risk of silent cerebrovascular lesions. Fibrinogen and 24- hour BP had additive effects on silent cerebrovascular lesions.Conclusion - The 24- hour ABP and plasma fibrinogen levels were closely and independently associated with the risk of silent cerebrovascular lesions including white matter hyperintensity and lacunar infarct.