Effect Of Mean Systolic Blood Pressure And Circadian Rhythm Of Blood Pressure On Cerebral White Matter Lesion In The Non-Stroke Elderly

Objective:To investigate the effect of mean systolic blood pressure,circadian rhythm of blood pressure and other factors on cerebral white matter lesion(WML)in the non-stroke elderly.Methods:The general clinical data of 105 elderly patients admitted in Department of Geriatrics,JiangSu Province Hospital during 2015～2016 were retrospectively analyzed.Cerebral MRI and ambulatory blood pressure monitoring were checked in all the participants,all of their general clinical data and laboratory results were completed.According to MRI and Fazekas rating scale,all participants were divided into the absent-mild WML group(0 to 2 points)and the moderate-severe group(3 to 6 points).Clinical data that may be related to white matter lesion and the results of 24-hour ambulatory blood pressure monitoring were compared between two groups respectively.The factors presenting significant difference were then taken into logistic regression analysis.Results:Compared to absent-mild WML group,the moderate-severe group showed advanced age,more female,more history of hypertension rate and coronary heart disease,less utility of combined antihypertensive drugs,lower eGFR and lower proportion of dipper blood pressure,higher 24hmSBP,DmSBP,NmSBP with a statistical significance(P<0.05)respectively.Logistic regression analysis demonstrated that age,24hmSBP and reverse-dipper blood pressure were independent risk factors of white matter lesion.Conclusion:Age,24hmSBP and reverse-dipper blood pressure are independent risk factors of white matter lesion in the non-stroke elderly.It will contribute to preventing the occurrence and progression of WML in the non-stroke elderly by controlling blood pressure strictly and maintaining a normal circadian rhythm of blood pressure with the fact that high SBP is common in the elderly.