Hypertension, Vol 16, 692-699, Copyright © 1990 by American Heart Association
K Shimada, A Kawamoto, K Matsubayashi and T Ozawa
Does the average daily blood pressure correlate with hypertensive
cerebrovascular disease better than the casual pressure, as has been
reported in other target organ involvement? We investigated the
associations of two abnormal findings on brain magnetic resonance imaging
suggestive of a vascular etiology, low intense foci (lacunae), and
periventricular hyperintense lesions on T1- and T2-weighted images, with
both office and average daily blood pressure values in a population of 73
healthy normotensive and hypertensive elderly individuals (70 +/- 6 years
old). Lacunae were detected in 34 subjects (47%); the number per subject
ranged from 0 to 19 and was significantly correlated with advancing age.
Furthermore, these changes were supposedly related to the average of
noninvasive ambulatory (24-hour and during awake and asleep periods)
pressure recordings but not to office pressures. The grade of
periventricular hyperintensity was also significantly associated with
advancing age and the average of ambulatory systolic pressure recordings,
particularly during sleep, but not with office blood pressure. In
comparisons of normotensive, "office hypertensive," and hypertensive
subgroups, abnormalities on magnetic resonance imaging were appropriate to
the level of the 24-hour blood pressure measurements but not to that of
clinic pressure. In hypertensive patients, the presence of
electrocardiographic evidence of left ventricular hypertrophy was also
associated with greater abnormalities on magnetic resonance imaging. We
conclude that ambulatory blood pressure monitoring is superior to casual
pressure measurements in predicting latent cerebrovascular disease, which
is unexpectedly common in apparently healthy elderly subjects.
ARTICLES
Silent cerebrovascular disease in the elderly. Correlation with ambulatory pressure
Department of Medicine and Geriatrics, Kochi Medical School, Japan.
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|
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|
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|
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