Age and Diastolic Blood Pressure Play an Important Role in the Progression of White Matter Lesions: A Meta-Analysis

2020 ◽  
Vol 83 (4) ◽  
pp. 351-359
Author(s):  
Dong Zhang ◽  
Yi Tang ◽  
Jian Ge ◽  
Yumeng Liu ◽  
Jing Jin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Diastolic Blood Pressure ◽  
Odds Ratio ◽  
Meta Analysis ◽  
White Matter Lesions ◽  
Microvascular Disease ◽  
Related Literature ◽  
Mesh Terms ◽  
The Relationship

Introduction: White matter lesions (WMLs) are currently considered as a cerebral microvascular disease, and hypertension is considered as its most important risk factor. This study analysis systematically evaluated the effects of systolic blood pressure (SBP) and diastolic blood pressure (DBP) on the progression of WMLs. Methods: We searched the MeSH terms: “white matter,” “blood pressure,” “hypertension,” “Leukoencephalopathy,” and “leukoaraiosis” on PubMed and Cochrane from January 2000 to August 2019. A total of 12 closely related literature were included for research. Results: The results of the meta-analysis showed that the increase of both SBP and DBP can promote the progression of WMLs (respectively, odds ratio [OR] = 2.90, 95% confidence interval [CI] 2.86–2.94; OR = 3.13, 95% CI 3.03–3.23). Subgroup analysis found that patients with hypertension aged younger than 70 years are at a greater risk of WML progression when their DBP increased (OR = 4.69, 95% CI 3.31–6.65). Conclusion: The relationship between DBP and WMLs is closer than that of SBP. Also, the risk of WML progression in patients aged under 70 years was higher than that in patients aged over 70 years. Furthermore, when DBP is elevated in patients younger than 70 years of age, the risk of WML progression may be higher. Therefore, it is expected that more researchers will attach importance to the change in DBP and identify the range of blood pressure and strategies that control DBP, thus contributing to delay the progression of WMLs.

scholarly journals Blood Pressure Variability and Cerebral Small Vessel Disease

Stroke ◽  
2020 ◽  
Vol 51 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Yuan Ma ◽  
Alex Song ◽  
Anand Viswanathan ◽  
Deborah Blacker ◽  
Meike W. Vernooij ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Odds Ratio ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Meta Analysis ◽  
Random Effect ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease

Background and Purpose— Blood pressure (BP) variability may increase the risk of stroke and dementia. It remains inconclusive whether BP variability is associated with cerebral small vessel disease, a common and potentially devastating subclinical disease that contributes significantly to both stroke and dementia. Methods— A systematic review and meta-analysis of prospective cohort studies that examined the association between BP variability and the presence or progression of established markers of cerebral small vessel disease, including white matter hyperintensities, lacunes, and microbleeds on magnetic resonance imaging. We searched MEDLINE, EMBASE, and Web of Science. Ten studies met the criteria for qualitative synthesis and 7 could be included in the meta-analysis. Data were synthetized using random-effect models. Results— These studies included a total of 2796 individuals aged 74 (mean) ±4 (SD) years, with a median follow-up of 4.0 years. A one SD increase in systolic BP variability was associated with increased odds of the presence or progression of white matter hyperintensities (odds ratio, 1.26 [95% CI, 1.06–1.50]). The association of systolic BP variability with the presence of lacunes (odds ratio, 0.93 [95% CI, 0.74–1.16]) and the presence of microbleeds (odds ratio, 1.13 [95% CI, 0.89–1.44]) were not statistically significant. Conclusions— A larger BP variability may be associated with a higher risk of having a higher burden of white matter hyperintensities. Targeting large BP variability has the potential to prevent cerebral small vessel disease and thereby reducing the risk of stroke and dementia. The potential issue of reverse causation and the heterogeneity in the assessment of cerebral small vessel disease markers should be better addressed in future studies.

scholarly journals Higher Blood Pressure is Associated with Greater White Matter Lesions and Brain Atrophy: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 637
Author(s):  
Khawlah Alateeq ◽  
Erin I. Walsh ◽  
Nicolas Cherbuin
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Meta Analysis ◽  
Full Range ◽  
White Matter Lesions ◽  
Hippocampal Volume ◽  
Cross Sectional ◽  
Standard Deviation Increase ◽  
Brain Volumes ◽  
Dependent Relationship

Background: To summarise and quantify the evidence on the association between Blood pressure (BP), white matter lesions (WMLs), and brain volumes. Method: Electronic databases PubMed, Scopus, and Clarivate were searched in February 2020 using an established methodology and pre-determined search terms. Studies were eligible for inclusion if they reported on the association between BP and WMLs or brain volume in cognitively healthy individuals, while adjusting for age and intra-cranial volume. Results: Searches yielded 7509 articles, of which 52 (26 longitudinal and 33 cross-sectional), were eligible and had a combined sample size of 343,794 individuals. Analyses found that 93.7% of studies reported that higher BP was associated with poorer cerebral health (higher WMLs and lower brain volumes). Meta-analysis of compatible results indicated a dose-dependent relationship with every one standard deviation increase in systolic BP (SBP) above 120 mmHg being associated with a 11.2% (95% CI 2.3, 19.9, p = 0.0128) increase in WMLs and −0.13% (95% CI −0.25, −0.023, p = 0.0183) smaller hippocampal volume. Conclusion: The association between BP and brain volumes appears across the full range of BP measurements and is not limited to hypertensive individuals. Higher BP in community-residing individuals is associated with poorer cerebral health.

scholarly journals CATECHOL O-METHYLTRANSFERASE VAL158/MET AND HYPERTENSION: A META-ANALYSIS

2021 ◽  
Vol 21 (2) ◽  
pp. 162-167
Author(s):  
Mohammed A. Merzah ◽  
Shewaye Natae
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Web Of Science ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Case Control Studies ◽  
Preventable Risk Factor ◽  
Relationship Of ◽  
The Relationship

Hypertension is a preventable risk factor of cardiovascular diseases. It is considered a major cause of CVD-morbidity and mortality worldwide. Some risk factors and prevention strategies related to hypertension were studied intensively, however, with growing the burden of this disorder and genetic has become the dominant field of treating diseases, still, specific genes involved in increasing blood pressure remain to be identified. This meta-analysis was conducted to assess the relationship of COMT Val158/Met variation to high systolic and diastolic blood pressure. PubMed and Web of Science (WOS) were intensively searched for the genetic association on the link of COMT Val158/Met to hypertension. The search was done up to October 15th 2020 and updated on November 22nd 2020. Two investigators were independently extracting data and evaluating the risk of bias using the Cochrane risk of bias tool. Q-genie tool was used to assess the quality of all included articles. Met-dominant model (Met/Met + Val/Met vs Val/Val) showed a significant association to systolic and diastolic blood pressure with a pooled standardized mean difference of -0.215 and 95%CI [-0.399 to -0.0300] and -0.205, 95%CI [-0.390 to -0.0197], respectively. Met allele was significantly related to high systolic and diastolic blood pressure. However, high-quality, case-control studies are lacking.

scholarly journals Higher diastolic blood pressure aged 40‐44 is associated with declining cognition and increasing white matter lesions over 8‐12 year follow up.

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Ruth Peters ◽  
Ying Xu ◽  
Nicolas Cherbuin ◽  
Perminder S. Sachdev ◽  
Kaarin J Anstey
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Diastolic Blood Pressure ◽  
White Matter Lesions

scholarly journals Diastolic Blood Pressure Levels and Ischemic Stroke Incidence in Older Adults With White Matter Lesions

2010 ◽  
Vol 66A (1) ◽  
pp. 74-81 ◽  
Author(s):  
Shoshana Reshef ◽  
Linda Fried ◽  
Norman Beauchamp ◽  
Daniel Scharfstein ◽  
Daniel Reshef ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Ischemic Stroke ◽  
White Matter ◽  
Diastolic Blood Pressure ◽  
White Matter Lesions ◽  
Stroke Incidence

scholarly journals Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study

2007 ◽  
Vol 92 (3) ◽  
pp. 841-845 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Trine Bjøro ◽  
Tom I. L. Nilsen ◽  
Lars J. Vatten
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Outcome Measures ◽  
Odds Ratio ◽  
Reference Range ◽  
Positive Association ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Cross Sectional ◽  
Population Based Study

Abstract Context: The association between thyroid function and blood pressure is insufficiently studied. Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. Design and Setting: This was a cross-sectional, population-based study. Subjects: A total of 30,728 individuals without previously known thyroid disease were studied. Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (>140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women. Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.

scholarly journals Evening anti-hypertensive dosing improves blood pressure control and reduce cardiovascular events in hypertensive: a meta-analysis of 40 trials in 44,167 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.P Sunjaya ◽  
A.F Sunjaya
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Control ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Pressure Control ◽  
Controlled Trials ◽  
Night Time ◽  
Randomized Controlled

Abstract Introduction Nocturnal blood pressure (BP) and early morning BP surge have consistently been found to be a better prognostic marker of cardiovascular outcome than daytime BP. Most anti-hypertensive show greater blood pressure-lowering effect in the first 12 hours compared to the next 12 hours. Several prospective studies have shown better BP regulation and improved cardiovascular risk when anti-hypertensive are ingested at bedtime versus at awakening. Purpose In patients with hypertension does evening dosing of anti-hypertensive compared to morning dosing led to better reduction in pressure, blood pressure control and reduced cardiovascular morbidity. Methods A meta-analysis was performed based on randomized controlled trials obtained from Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline and Medline ahead of print published between 2000 and 2020. Main outcome measures include mean 24 hour systolic and diastolic blood pressure, cardiovascular events as well as prevalence of blood pressure in control. Data synthesis and analysis was done using RevMan 5.3 using a random effects model. Results A total of 40 randomized controlled trials, representing 44,167 patients were included in this meta-analysis. Most studies evaluate the administration of mixed anti-hypertensive with ≥1 medication ingested at bedtime, calcium channel blockers (CCBs) or angiotensin receptor blockers (ARBs) with sample sizes ranging from 30 to 19,084 patients. Evening administration of anti-hypertensive was found to significantly lower 24-hour systolic blood pressure (Mean difference = −1.05, 95% CI: −2.01 to −0.10, p=0.03) and 24-hour diastolic blood pressure (Mean difference = −1.09, 95% CI: −1.68 to −0.50, p=0.0003). Prevalence of controlled blood pressure was found to significantly increase with evening dosing (RR=1.15, 95% CI: 1.03 to 1.28, p=0.01). Significant reduction in cardiovascular events were found in the evening dosing group (RR=0.48, 95% CI: 0.03 to 0.68, p=<0.00001). Discussion Reduction in night-time blood pressure especially among non-dippers as reported in previous studies and higher prevalence of controlled blood pressure may explain the greater than 50% reduction in cardiovascular events in the evening dosing group. This marked benefit from a simple and inexpensive strategy certainly has great potential to benefit patients in practice. Even so, few studies have reported the prevalence of blood pressure in control (9 studies) and cardiovascular events (6 studies). Few has also studied this in geriatric populations where night-time hypotension and hypoperfusion may bring the most impact. Conclusion For patients with hypertension, evening dosing significantly improves blood pressure control and reduces the risk for cardiovascular events. Careful selection of anti-hypertensive administration time in patients is recommended given the possible benefits. Anti Hypertensive Dosing Forest Plot Funding Acknowledgement Type of funding source: None

scholarly journals Association of Ambulatory Blood Pressure and Heart Rate With Advanced White Matter Lesions in Ischemic Stroke Patients

2013 ◽  
Vol 27 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Hyuk Sung Kwon ◽  
Young-Hyo Lim ◽  
Hyun Young Kim ◽  
Hee-Tae Kim ◽  
Hyung-Min Kwon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Ischemic Stroke ◽  
White Matter ◽  
Ambulatory Blood Pressure ◽  
White Matter Lesions ◽  
Stroke Patients

scholarly journals Blood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions

2017 ◽  
Vol 9 ◽  
Author(s):  
Kyle C. Kern ◽  
Clinton B. Wright ◽  
Kaitlin L. Bergfield ◽  
Megan C. Fitzhugh ◽  
Kewei Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Blood Pressure Control ◽  
Cerebral Atrophy ◽  
White Matter Lesions ◽  
Pressure Control ◽  
Small Vessel
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