Visit-to-visit blood pressure variability is associated with periventricular white matter hyperintensity in healthy hypertensive elderly Chinese

Abstract

Background: Visit-to-visit blood pressure variability (BPV) has been reported to be associated with the severity and prognosis of symptomatic stroke, but its correlation with silent stroke is unclear. We aimed to evaluate the relationship between BPV and silent cerebral vascular lesions (SCVL). Methods: A total of 239 healthy hypertensive Chinese aged more than 65 years were recruited. SCVLs including silent brain infarcts (BIs), microbleeds (MBs), and white matter hyperintensity (WMH) were determined by magnetic resonance images on a 3T scanner. The severity of WMH was rated using the Fazekas white matter scale. Previous 3-year blood pressure measurements were collected from the electronic medical record. BPV parameters—including standard deviation, coefficient of variation, successive variation, and variation independent of mean blood pressure—were calculated. Statistical analyses were performed to evaluate the significance of relationships. Result: Of the patients, 26 (10.9%) and 12 (5.0%) had severe periventricular WMH and deep WMH (Fazekas score = 3), respectively. Both systolic and diastolic BPV parameters were correlated with the severity of periventricular WMH (P < 0.05) but not the severity of deep WMH, presence of BIs or MBs. The relationship between BPV parameters and periventricular WMH still existed after adjustment for age and other factors. Conclusion: BPV was an independent predictor of severe periventricular WMH in healthy hypertensive elderly.