Relationships between 24-Hour Blood Pressures, Subcortical Ischemic Lesions, and Cognitive Impairment

• Published in: Journal of clinical neurology (Seoul, Korea) Vol. 5; no. 3; pp. 139 - 145
• Main Authors: Kim, Jung Eun, Shin, Ji Soo, Jeong, Jee Hyang, Choi, Kyong Gyu, Park, Kee Duk, Kim, SangYun
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Neurological Association 01.09.2009; 대한신경과학회
• Subjects: Original; 신경과학; 24-hour blood pressure values; subcortical vascular dementia; subcortical vascular mild cognitive impairment
• ISSN: 1738-6586; 2005-5013
• DOI: 10.3988/jcn.2009.5.3.139

The most important treatment for subcortical vascular dementia (SVaD) is controlling the blood pressure (BP). However, the few studies that have investigated the relationships between diurnal BP rhythm and subcortical ischemic vascular cognitive impairment have produced inconclusive results. In the study presented here, the 24-hour BP values of three groups of subjects-patients with subcortical vascular mild cognitive impairment (SvMCI), patients with SVaD, and normal controls-were compared using working criteria and 24-hour ambulatory BP (ABP) monitoring. The subjects (42 patients with SVaD, 37 patients with SvMCI, and 30 controls) were selected according to the study's inclusion/exclusion criteria. All subjects underwent brain magnetic resonance (MR) imaging and MR angiography, detailed neuropsychological testing, and 24-hour ABP monitoring. The prevalence of nondippers differed markedly between the control group and both the SVaD and SvMCI groups. Loss of nocturnal dipping was significantly associated with SVaD [odds ratio (OR), 4.827; 95% confidence interval (CI), 1.07-12.05]. It was found that SVaD is associated with loss of nocturnal BP dipping combined with increased pulse pressure and systolic BP (SBP) variability. Correction of these factors could therefore be important in the prevention of SVaD, independent of measures used to reduce BP.