Correlation between blood pressure variability and cerebral artery stenosis in patients with ischemic cerebrovascnlar disease

Abstract

Objective To investigate the relationship of blood pressure variability (BPV) with cerebral artery stenosis in patients with ischemic cerebrovascular disease. Methods Two hundred and six consecutive patients with ischemic cerebrovascular disease,admitted to our hospital from November 2006 to June 2010, were chosen in our study; these patients underwent arcus aorta and cerebral angiographies, and were monitored the ambulatory blood pressure. And then, according to the angiographic findings, the risk factors and relevant clinical data of different groups were analyzed.Results (1) Seventy-five of the 206 patients had normal findings in angiography and 131 had occlusive lesions of different degrees,among which 32.1％ (42) had only extracranial artery disease (EAD),29.0％(38) had only intracranial artery disease (IAD),and 38.9％ (51) had both EAD and IAD.In total,the incidence of EAD was 71.0％ (93),which was higher than that of IAD (67.9％,89).(2) As compared with those in the normal group,standard deviation of 24 h systolic blood pressure (24hSBPSD),standard deviation of 24 h diastolic blood pressure (24hDBPSD),day SBPSD (dSBPSD),day DBPSD (dDBPSD),night SBPSD (nSBPSD) and night DBPSD (nDBPSD) were significantly higher in the cerebral artery stenosis group (P＜0.05). (3) The prevalence of cerebral artery steonsis was positively correlated with coefficient of systolic variation (r=0.918, P=0.002); no significant correlation was noted between coefficient of 24 h diastolic variation and the prevalence of cerebral artery stenosis (P＞0.05); coefficient of 24 h mean systolic variation was positively correlated with prevalence of cerebral artery stenosis (r=0.936,P=0.001); and 24 h mean diastolic blood pressure was negatively correlated with prevalence of cerebral artery stenosis (P＞0.05). (4) Multivariate regression analysis indicated that cerebral steno-occlusive lesion was positively associated with 24 h mean systolic blood pressure and coefficient of variation of 24 h blood pressure.(5) Hyperlipidemia was the independent risk factor for EAD; advanced age was the independent risk factor for IAD; and smoke was the independent risk factor for EAD and IAD; coronary artery disease was the independent risk factor for EAD,and EAD combined with IAD.Conclusion Cerebral artery stenosis is independently associated with standard deviation of mean of blood pressure and coefficient of variation systolic blood pressure; the contribution of various risk factors,including hypertension,hyperlipidemia,coronary artery disease,smoking,advanced age,diabetes and hyperho-mocysteinemia, have some correlation with the distribution mode of stenosis; BPV is an independent risk factor for cerebral artery stenosis,but not related to the distribution mode of stenosis. Key words: Ischemic cerebrovascular disease; Cerebral arterial stenosis; Coefficient of blood pressure variability; Average blood pressure standard deviation; Risk factor