Association of Central Systolic Blood Pressure With Intracerebral Small Vessel Disease in Japanese

作者：Ochi Namiko; Kohara Katsuhiko^*; Tabara Yasuharu; Nagai Tokihisa; Kido Tomoko; Uetani Eri; Ochi Masayuki; Igase Michiya; Miki Tetsuro

来源：American Journal of Hypertension, 2010, 23(8): 889-894.

DOI：10.1038/ajh.2010.60

• Arterial stiffness
• blood pressure
• carotid flow augmentation index
• central blood pressure
• cerebral small vessel diseases
• hypertension

BACKGROUND
Recent studies have reported the association between advanced arterial stiffness and brain small vessel diseases (SVDs). two possible hemodynamic mechanisms, increases in central blood pressure (BP) and pulsatile flow load to the brain, have been speculated to link arterial stiffness and SVD. the carotid flow augmentation index (AI) has been proposed as an index of pulsatile flow to the brain. We compared its association with brain SVD with that of central BP in a general population.
METHODS
Subjects were 500 individuals free from symptomatic cardiovascular diseases with a mean age of 66.9 +/- 8.4 years. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. Carotid flow AI was obtained by Doppler ultrasonography. the presence of silent cerebral lacunar infarcts (SCI) was determined as a manifestation of SVD by 3-tesla magnetic resonance imaging (MRI). second peak radial systolic BP (SBP2) and pulse pressure (PP2) were used as estimates of central BP.
RESULTS
baPWV was significantly associated with radial BP2 (r = 0.55, P < 0.0001) but not with carotid flow AI (r = 0.03, P = 0.51). Radial BPs and baPWV, but not flow AI, were significantly higher in subjects with SCI. Radial SBP2 had higher odds ratio for the presence of sCI than brachial SBP, PP, and radial PP2. Logistic regression analysis showed that radial SBP2, but not flow AI, was independently related to the presence of sCI.
CONCLUSION
These findings indicate that the SBP2, an estimate of central SBP, is significantly associated with the presence of SVD in an apparently healthy general population.

• 出版日期2010-8