Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis

Bum Joon Kim, Sun U Kwon, Jong-Moo Park, Yang-Ha Hwang, Sung Hyuk Heo, Joung-Ho Rha, Jun Lee, Man-Seok Park, Joon-Tae Kim, Hee-Jung Song, Jong-Ho Park, Sungwook Yu, Soo Joo Lee, Tai Hwan Park, Jae-Kwan Cha, Hyung-Min Kwon, Eung-Gyu Kim, Seung-Hoon Lee, Ji Sung Lee, Juneyoung Lee & 1 others Dong-Wha Kang

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS).

METHODS: This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50% stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs.

RESULTS: Of the 111 enrolled patients, 69 patients (67.6%) demonstrated WML growth and 15 patients (13.7%) had NILs. Patients with higher BPV demonstrated a more WML growth (50% vs. 61.8% vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4% vs. 5.4% vs. 29.7%; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95% confidence interval (CI) = 1.005-1.101); P = 0.03] and home BPV [OR = 1.149 (95% CI = 1.013-1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95% CI = 0.874-0.984); P = 0.02] and high home BPV [OR = 1.287 (95% CI = 1.086-1.526); P = 0.004] were independently associated with NILs at follow-up.

CONCLUSIONS: High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.

Original languageEnglish
Pages (from-to)918-924
Number of pages7
JournalAmerican Journal of Hypertension
Volume32
Issue number9
DOIs
StatePublished - 14 Aug 2019

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Intracranial Arteriosclerosis
Blood Pressure
Growth
Hypertension
Stroke
Odds Ratio
Confidence Intervals
Office Visits
House Calls
White Matter
Pathologic Constriction

Cite this

Kim, Bum Joon ; Kwon, Sun U ; Park, Jong-Moo ; Hwang, Yang-Ha ; Heo, Sung Hyuk ; Rha, Joung-Ho ; Lee, Jun ; Park, Man-Seok ; Kim, Joon-Tae ; Song, Hee-Jung ; Park, Jong-Ho ; Yu, Sungwook ; Lee, Soo Joo ; Park, Tai Hwan ; Cha, Jae-Kwan ; Kwon, Hyung-Min ; Kim, Eung-Gyu ; Lee, Seung-Hoon ; Lee, Ji Sung ; Lee, Juneyoung ; Kang, Dong-Wha. / Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis. In: American Journal of Hypertension. 2019 ; Vol. 32, No. 9. pp. 918-924.
@article{c7d32418ae2f4472afc0599a141406e3,
title = "Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis",
abstract = "BACKGROUND: High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS).METHODS: This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50{\%} stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs.RESULTS: Of the 111 enrolled patients, 69 patients (67.6{\%}) demonstrated WML growth and 15 patients (13.7{\%}) had NILs. Patients with higher BPV demonstrated a more WML growth (50{\%} vs. 61.8{\%} vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4{\%} vs. 5.4{\%} vs. 29.7{\%}; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95{\%} confidence interval (CI) = 1.005-1.101); P = 0.03] and home BPV [OR = 1.149 (95{\%} CI = 1.013-1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95{\%} CI = 0.874-0.984); P = 0.02] and high home BPV [OR = 1.287 (95{\%} CI = 1.086-1.526); P = 0.004] were independently associated with NILs at follow-up.CONCLUSIONS: High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.",
author = "Kim, {Bum Joon} and Kwon, {Sun U} and Jong-Moo Park and Yang-Ha Hwang and Heo, {Sung Hyuk} and Joung-Ho Rha and Jun Lee and Man-Seok Park and Joon-Tae Kim and Hee-Jung Song and Jong-Ho Park and Sungwook Yu and Lee, {Soo Joo} and Park, {Tai Hwan} and Jae-Kwan Cha and Hyung-Min Kwon and Eung-Gyu Kim and Seung-Hoon Lee and Lee, {Ji Sung} and Juneyoung Lee and Dong-Wha Kang",
note = "{\circledC} American Journal of Hypertension, Ltd 2019. All rights reserved. For Permissions, please email: journals.permissions@oup.com.",
year = "2019",
month = "8",
day = "14",
doi = "10.1093/ajh/hpz068",
language = "English",
volume = "32",
pages = "918--924",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "9",

}

Kim, BJ, Kwon, SU, Park, J-M, Hwang, Y-H, Heo, SH, Rha, J-H, Lee, J, Park, M-S, Kim, J-T, Song, H-J, Park, J-H, Yu, S, Lee, SJ, Park, TH, Cha, J-K, Kwon, H-M, Kim, E-G, Lee, S-H, Lee, JS, Lee, J & Kang, D-W 2019, 'Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis', American Journal of Hypertension, vol. 32, no. 9, pp. 918-924. https://doi.org/10.1093/ajh/hpz068

Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis. / Kim, Bum Joon; Kwon, Sun U; Park, Jong-Moo; Hwang, Yang-Ha; Heo, Sung Hyuk; Rha, Joung-Ho; Lee, Jun; Park, Man-Seok; Kim, Joon-Tae; Song, Hee-Jung; Park, Jong-Ho; Yu, Sungwook; Lee, Soo Joo; Park, Tai Hwan; Cha, Jae-Kwan; Kwon, Hyung-Min; Kim, Eung-Gyu; Lee, Seung-Hoon; Lee, Ji Sung; Lee, Juneyoung; Kang, Dong-Wha.

In: American Journal of Hypertension, Vol. 32, No. 9, 14.08.2019, p. 918-924.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Blood Pressure Variability Is Associated With White Matter Lesion Growth in Intracranial Atherosclerosis

AU - Kim, Bum Joon

AU - Kwon, Sun U

AU - Park, Jong-Moo

AU - Hwang, Yang-Ha

AU - Heo, Sung Hyuk

AU - Rha, Joung-Ho

AU - Lee, Jun

AU - Park, Man-Seok

AU - Kim, Joon-Tae

AU - Song, Hee-Jung

AU - Park, Jong-Ho

AU - Yu, Sungwook

AU - Lee, Soo Joo

AU - Park, Tai Hwan

AU - Cha, Jae-Kwan

AU - Kwon, Hyung-Min

AU - Kim, Eung-Gyu

AU - Lee, Seung-Hoon

AU - Lee, Ji Sung

AU - Lee, Juneyoung

AU - Kang, Dong-Wha

N1 - © American Journal of Hypertension, Ltd 2019. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PY - 2019/8/14

Y1 - 2019/8/14

N2 - BACKGROUND: High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS).METHODS: This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50% stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs.RESULTS: Of the 111 enrolled patients, 69 patients (67.6%) demonstrated WML growth and 15 patients (13.7%) had NILs. Patients with higher BPV demonstrated a more WML growth (50% vs. 61.8% vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4% vs. 5.4% vs. 29.7%; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95% confidence interval (CI) = 1.005-1.101); P = 0.03] and home BPV [OR = 1.149 (95% CI = 1.013-1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95% CI = 0.874-0.984); P = 0.02] and high home BPV [OR = 1.287 (95% CI = 1.086-1.526); P = 0.004] were independently associated with NILs at follow-up.CONCLUSIONS: High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.

AB - BACKGROUND: High blood pressure variability (BPV) is associated with recurrent stroke. We investigated the association between BPV, new ischemic lesions (NILs), and white matter lesion (WML) growth in patients with ischemic stroke due to intracranial atherosclerosis (ICAS).METHODS: This study was performed as a post-hoc analysis of the STABLE-ICAS trial, which enrolled subacute ischemic stroke patients with symptomatic ICAS (>50% stenosis) and hypertension. BPV was measured at the office (visit by visit) and at home (day by day). Patients were divided into 3 groups (tertiles) according to their home BPV. WML growth and the occurrence of NILs were compared among the 3 groups. Multivariable analyses were performed to identify the independent risk factors of WML growth and NILs.RESULTS: Of the 111 enrolled patients, 69 patients (67.6%) demonstrated WML growth and 15 patients (13.7%) had NILs. Patients with higher BPV demonstrated a more WML growth (50% vs. 61.8% vs. 83.8; P = 0.02, by tertiles) and more NILs (5.4% vs. 5.4% vs. 29.7%; P = 0.002, by tertiles). In multivariable analyses, old age [odds ratio (OR) = 1.052 (95% confidence interval (CI) = 1.005-1.101); P = 0.03] and home BPV [OR = 1.149 (95% CI = 1.013-1.304); P = 0.02] were independently associated with WML growth. Low mean diastolic blood pressure [OR = 0.913 (95% CI = 0.874-0.984); P = 0.02] and high home BPV [OR = 1.287 (95% CI = 1.086-1.526); P = 0.004] were independently associated with NILs at follow-up.CONCLUSIONS: High BPV is associated with WML growth and NIL in ischemic stroke patients with symptomatic ICAS. BPV monitoring at home may be helpful.

U2 - 10.1093/ajh/hpz068

DO - 10.1093/ajh/hpz068

M3 - Article

VL - 32

SP - 918

EP - 924

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 9

ER -