Please use this identifier to cite or link to this item: https://hdl.handle.net/1959.11/51636
Title: Day-to-Day Home Blood Pressure Variability is Associated with Cerebral Small Vessel Disease Burden in a Memory Clinic Population
Contributor(s): de Heus, Rianne A A (author); Reumers, Stacha F I (author); van der Have, Alba (author); Tumelaire, Maxime (author); Tully, Phillip J  (author)orcid ; Claassen, Jurgen A H R (author)
Publication Date: 2020
Early Online Version: 2020-03-24
Open Access: Yes
DOI: 10.3233/JAD-191134
Handle Link: https://hdl.handle.net/1959.11/51636
Abstract: 

Background: High visit-to-visit blood pressure variability (BPV) has been associated with cognitive decline and cerebral small vessel disease (cSVD), in particular cerebrovascular lesions. Whether day-to-day BPV also relates to cSVD has not been investigated.
Objective: To investigate the cross-sectional association between day-to-day BPV and total cSVD MRI burden in older memory clinic patients.
Methods: We included outpatients referred to our memory clinic, who underwent cerebral MRI as part of their diagnostic assessment. We determined the validated total cSVD score (ranging from 0-4) by combining four markers of cSVD that were visually rated. Home blood pressure (BP) measurements were performed for one week, twice a day, according to international guidelines. BPV was defined as the within-subject coefficient of variation (CV; standard deviation/mean BP*100). We used multivariable ordinal logistic regression analyses adjusted for age, sex, smoking, diabetes, antihypertensive medication, history of cardiovascular disease, and mean BP.
Results: For 82 patients (aged 71.2±7.9 years), mean home BP was 140/79±15/9 mmHg. Dementia and mild cognitive impairment were diagnosed in 46% and 34%, respectively. 78% had one or more markers of cSVD. Systolic CV was associated with cSVD burden (adjusted odds ratio per point increase in CV = 1.29, 95% confidence interval = 1.04-1.60, p = 0.022). There were no differences in diastolic CV and mean BP between the cSVD groups. When we differentiated between morning and evening BP, only evening BPV remained significantly associated with total cSVD burden.
Conclusion: Day-to-day systolic BPV is associated with cSVD burden in memory clinic patients. Future research should indicate whether lowering BPV should be included in BP management in older people with memory complaints.

Publication Type: Journal Article
Source of Publication: Journal of Alzheimer's Disease, 74(2), p. 463-472
Publisher: IOS Press
Place of Publication: Netherlands
ISSN: 1875-8908
1387-2877
Fields of Research (FoR) 2020: 520304 Health psychology
Socio-Economic Objective (SEO) 2020: 200502 Health related to ageing
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Psychology

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