Long-term blood pressure fluctuation and cerebrovascular disease in an elderly cohort.
Long-term blood pressure fluctuation and cerebrovascular disease in an elderly cohort.
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DOI：
10.1001/archneurol.2010.70
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发表时间：
2010-05
影响因子：
--
通讯作者：
Mayeux, Richard
中科院分区：
文献类型：
--
作者：
Brickman, Adam M.;Reitz, Christiane;Luchsinger, Jose A.;Manly, Jennifer J.;Schupf, Nicole;Muraskin, Jordan;DeCarli, Charles;Brown, Truman R.;Mayeux, Richard
探讨血压水平及长期血压波动与脑血管病的关系。参与者在扫描前每3个月、24个月接受一次结构性MRI和BP测量。我们推导出每个参与者在3个时间间隔内平均血压的平均值和标准差（SD），并将其分为四组，定义为高于和低于组中位数（≤ 96.48 mmHg或> 96.48 mmHg），并进一步细分为中位数标准差（低于SD ≤ 7.21 mmHg或高于SD > 7.21 mmHg）。该方案产生了四个组，代表BP的全范围和BP的波动。我们检查了这些组之间白色高信号（WMH）体积和脑梗死的差异。华盛顿高地-英伍德哥伦比亚老龄化项目，一项对曼哈顿北方老年人进行的基于社区的流行病学研究。686名非痴呆老年人接受了结构MRI，并在三次研究访视期间进行了BP测量。四组WMH体积以线性方式增加，最低平均值/最低SD组的WMH体积最低，最高平均值/最高SD组的WMH体积最高（F（3，610）=27.43，p=0.0017）。各组间梗死发生率也呈单调增加（从22%增加至41%;趋势p =0.004）。与血压波动小的低血压个体相比，脑血管疾病的风险随着血压升高和血压波动而增加。鉴于脑血管疾病与残疾有关，研究结果表明，干预措施应侧重于长期波动的血压以及血压升高。
To determine the association of blood pressure (BP) level and longterm fluctuation in BP with cerebrovascular disease. Participants received structural MRI and BP measurements in 3, 24 month intervals prior to scanning. We derived the mean and standard deviation (SD) of the mean BP for each participant over the 3 intervals and divided them into four groups defined as above and below the group median (≤ 96.48 mmHg or >96.48mmHg) and further subdivided by the median standard deviation (below SD ≤ 7.21 mmHg or above SD > 7.21 mmHg). This scheme yielded four groups representing the full range of BP and fluctuations in BP. We examined differences in white matter hyperintensity (WMH) volume and brain infarctions across these groups. The Washington Heights-Inwood Columbia Aging Project, a community-based epidemiological study of older adults from northern Manhattan. 686 non-demented older adults who received structural MRI and had BP measurements over three study visits. WMH volume increased across the four groups in a linear fashion with the lowest WMH volume in the lowest mean/lowest SD group and the highest in the highest mean/highest SD group (F(3,610)=27.43, p=0.0017). Frequency of infarction also increased monotonically across groups (from 22% to 41%; p-for-trend=0.004). Compared to individuals with low BP with low fluctuations in BP, the risk of cerebrovascular disease increases with increasing BP and BP fluctuation. Given that cerebrovascular disease is associated with disability, findings suggest that interventions should focus on longterm fluctuating BP as well as elevated BP.
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影响因子：
2.3
作者：
Brickman, Adam M.;Zahra, Amir;Muraskin, Jordan;Steffener, Jason;Holland, Christopher M.;Habeck, Christian;Borogovac, Ajna;Ramos, Marco A.;Brown, Truman R.;Asllani, Iris;Stern, Yaakov
通讯作者：
Stern, Yaakov
影响因子：
5.6
作者：
Parati, Gianfranco;Faini, Andrea;Valentini, Mariaconsuelo
通讯作者：
Valentini, Mariaconsuelo
影响因子：
8.3
作者：
Holland, Christopher M.;Smith, Eric E.;Greenberg, Steven M.
通讯作者：
Greenberg, Steven M.
影响因子：
--
作者：
Brickman, Adam M.;Honig, Lawrence S.;Scarmeas, Nikolaos;Tatarina, Oksana;Sanders, Linda;Albert, Marilyn S.;Brandt, Jason;Blacker, Deborah;Stern, Yaakov
通讯作者：
Stern, Yaakov
影响因子：
--
作者：
Reitz, Christiane;Tang, Ming-Xin;Luchsinger, Jose A.
通讯作者：
Luchsinger, Jose A.