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J Clin Neurol. 2019 Apr;15(2):159-167. doi: 10.3988/jcn.2019.15.2.159. Epub 2019 Mar 11.

Interarm Blood Pressure Difference has Various Associations with the Presence and Burden of Cerebral Small-Vessel Diseases in Noncardioembolic Stroke Patients.

Author information

1
Department of Neurology, College of Medicine, Ewha Womans University, Seoul, Korea.
2
Departent of Neurology, College of Medicine, Korea University Guro Hostpital, Seoul, Korea.
3
Department of Neurology, College of Medicine, Ewha Womans University, Seoul, Korea. knstar@ewha.ac.kr.

Abstract

BACKGROUND AND PURPOSE:

An interarm blood pressure difference (IABD) is independently related to the occurrence of cardiovascular disease and mortality. Cerebral small-vessel diseases (SVDs) are important risk factors for stroke, cognitive dysfunction, and mortality. We aimed to determine whether IABD is related to cerebral SVDs.

METHODS:

This study included 1,205 consecutive noncardioembolic ischemic stroke patients as confirmed by brain MRI and simultaneously measured the bilateral brachial blood pressures. We investigated cerebral SVDs based on high-grade white-matter hyperintensities (HWHs), presence of cerebral microbleeds (CMBs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs) on brain MRI.

RESULTS:

In multivariate logistic regression, an interarm systolic blood pressure difference (IASBD) ≥10 mm Hg was independently related to the existence of HWHs [odds ratio (OR)=1.94, 95% CI=1.32-2.84, p=0.011] and had a tendency to be associated with the presence of HPVSs (OR=1.45, 95% CI=0.49-2.23, p=0.089) and ALIs (OR=1.42, 95% CI=0.96-2.11, p=0.052), but not with the presence of CMBs (OR=1.09, 95% CI=0.73-1.61, p=0.634). In multivariate linear regression adjusted for age, sex, and variables with p<0.1 in the univariate analysis, IASBD ≥10 mm Hg and interarm diastolic blood pressure difference ≥10 mm Hg were significantly correlated with an increased total burden of SVDs (β=0.080 and p=0.006, and β=0.065 and p=0.023, respectively).

CONCLUSIONS:

This study found that IABD ≥10 mm Hg was associated with the presence and increased burden of cerebral SVDs in noncardioembolic stroke patients. This suggests that IABD ≥10 mm Hg could be a useful indicator of the presence and burden of cerebral SVDs in stroke patients.

KEYWORDS:

asymptomatic lacunar infarctions; cerebral microbleeds; cerebral small-vessel diseases; interarm blood pressure difference; white-matter hyperintensities

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