Nocturnal blood pressure and silent cerebrovascular lesions in elderly Japanese.
Nocturnal blood pressure and silent cerebrovascular lesions in elderly Japanese.
复制标题
日本老年人的夜间血压和无症状脑血管病变。
作者：
N. Watanabe;Y. Imai;K. Nagai;Ichiro Tsuji;Hiroshi Satoh;M. Sakuma;H. Sakuma;J. Kato;Noriko Onodera;Masaaki Yamada;Fumiaki Abe;Shigeru Hisamichi;K. Abe
背景和目的
我们对来自日本北方的一个队列进行了一项横断面流行病学调查，使用动态血压监测和脑MRI，以确定夜间血压不适当的低或夜间血压过度下降是否可能导致老年人无症状脑血管病变。
方法
55岁以上且64岁以下（中年晚期; 24名男性和46名女性，60%的合格人群）和65岁以上且75岁以下（老年人; 29名男性和52名女性，91%的合格人群）的未治疗受试者参加了本研究。我们评估了夜间血压下降幅度（日间平均值-夜间平均值）或下降率（[日间平均值-夜间平均值]/日间平均值）与MRI上无症状脑血管病变发生率（腔隙性梗死数量或室周高信号程度）之间的关系。
结果
有1个或2个腔隙性脑梗死的老年女性夜间血压下降幅度或下降率明显高于无腔隙性脑梗死的老年女性。老年女性夜间血压下降幅度或下降率与室周高信号程度呈显著正相关。这种关系在中年晚期的女性中观察到，但在男性中没有观察到;这在老年男性中没有观察到。
结论
结果表明，不适当的低夜间血压，或夜间血压过度下降，与缺血性无症状脑血管病变，至少在老年妇女。治疗高血压在这样的妇女应管理与照顾，并考虑到夜间血压。
BACKGROUND AND PURPOSE
We conducted a cross-sectional epidemiological survey using ambulatory blood pressure monitoring and brain MRI in a cohort from northern Japan to determine whether an inappropriately low nocturnal blood pressure, or an excess fall in nocturnal blood pressure, might be responsible for silent cerebrovascular lesions in the elderly.
METHODS
Untreated subjects over 55 years and under 64 years of age (late middle age; 24 men and 46 women, 60% of eligible people) and over 65 years and under 75 years of age (elderly; 29 men and 52 women, 91% of eligible people) participated in the study. We evaluated the relationship between the amplitude (Daytime Average-Nighttime Average) or the rate ([Daytime Average-Nighttime Average]/Daytime Average) of the fall in nocturnal blood pressure and the incidence of silent cerebrovascular lesions on MRI (number of lacunar infarctions or extent of periventricular hyperintensity).
RESULTS
The amplitude or the rate of the fall in nocturnal blood pressure in elderly women with one or two lacunar infarctions was significantly higher than that in those without such infarctions. There was a significant positive correlation between the amplitude or the rate of the fall in nocturnal blood pressure and the extent of periventricular hyperintensity in the elderly women. This relationship was observed in women, but not in men, of late middle age; this was not seen in elderly men.
CONCLUSIONS
Results indicate that an inappropriately low nocturnal blood pressure, or an excessive fall in nocturnal blood pressure, is associated with ischemic silent cerebrovascular lesions, at least in elderly women. Treatment of hypertension in such women should be administered with care and with regard to nocturnal blood pressure.
影响因子：
37.8
作者：
DEVEREUX, RB;PICKERING, TG;LARAGH, JH
通讯作者：
LARAGH, JH