1. Association Between Blood Pressure Variability and Cerebral Small-Vessel Disease: A Systematic Review and Meta-Analysis
- Author
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Phillip J. Tully, Yuichiro Yano, Lenore J. Launer, Kazuomi Kario, Michiaki Nagai, Simon P. Mooijaart, Jurgen A. H. R. Claassen, Simona Lattanzi, Andrew D. Vincent, Christophe Tzourio, Kaarin J. Anstey, Nigel Beckett, Alexa S. Beiser, Jonathan Birns, Adam M. Brickman, Nicholas R. Burns, Mahir Cengiz, Suzanne Cosh, Rianne A. A. de Heus, Peter W. de Leeuw, Diana Dorstyn, Merrill F. Elias, J. Wouter Jukema, Masahiro Kikuya, Abraham A. Kroon, Rajiv Mahajan, Emer R. McGrath, Eric P. Moll van Charante, Toshiharu Ninomiya, Tomoyuki Ohara, Takayoshi Ohkubo, Emi Oishi, Ruth Peters, Edo Richard, Michihiro Satoh, Joseph Selvayanagam, Sudha Seshadri, David J. Stott, Stella Trompet, Willem A. van Gool, Tessa van Middelaar, Deborah A. Turnbull, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Duke University [Durham], and Radboud university [Nijmegen]
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Male ,medicine.medical_specialty ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,blood pressure measurement ,viruses ,Magnetic Resonance Imaging (MRI) ,MEDLINE ,Blood Pressure ,Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,systematic review ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Risk Factors ,Internal medicine ,Medicine ,Humans ,HEALTHY ,Stroke ,Aged ,blood pressure measurement/monitoring ,business.industry ,Systematic Review and Meta‐analysis ,Computerized Tomography (CT) ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,Prognosis ,meta-analysis ,monitoring ,Mean blood pressure ,Blood pressure ,meta‐analysis ,Meta-analysis ,Cerebral Small Vessel Diseases ,Hypertension ,Cardiology ,Cerebrovascular Disease/Stroke ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Small vessel ,blood pressure variability ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,white matter disease ,high blood pressure - Abstract
Background Research links blood pressure variability ( BPV ) with stroke; however, the association with cerebral small‐vessel disease ( CSVD ) remains unclear. As BPV and mean blood pressure are interrelated, it remains uncertain whether BPV adds additional information to understanding cerebrovascular morphological characteristics. Methods and Results A systematic review was performed from inception until March 3, 2019. Eligibility criteria included population, adults without stroke (BPV quantified by any metric over any duration; comparison, (1) low versus high or mean BPV and (2) people with versus without CSVD ; and outcomes, (1) CSVD as subcortical infarct, lacunae, white matter hyperintensities, cerebral microbleeds, or enlarged perivascular spaces; and (2) standardized mean difference in BPV . A total of 27 articles were meta‐analyzed, comprising 12 309 unique brain scans. A total of 31 odds ratios ( OR s) were pooled, indicating that higher systolic BPV was associated with higher odds for CSVD ( OR, 1.27; 95% CI, 1.14–1.42; I 2 =85%) independent of mean systolic pressure. Likewise, higher diastolic BPV was associated with higher odds for CSVD ( OR, 1.30; 95% CI, 1.14–1.48; I 2 =53%) independent of mean diastolic pressure. There was no evidence of a pairwise interaction between systolic/diastolic and BPV /mean OR s ( P =0.47), nor a difference between BPV versus mean pressure OR s ( P =0.58). Fifty‐four standardized mean differences were pooled and provided similar results for pairwise interaction ( P =0.38) and difference between standardized mean differences ( P =0.70). Conclusions On the basis of the available studies, BPV was associated with CSVD independent of mean blood pressure. However, more high‐quality longitudinal data are required to elucidate whether BPV contributes unique variance to CSVD morphological characteristics.
- Published
- 2020
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