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Diastolic blood pressure levels and ischemic stroke incidence in older adults with white matter lesions.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Diastolic blood pressure levels and ischemic stroke incidence in older adults with white matter lesions. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Reshef, S, Fried, L, Beauchamp, N, Scharfstein, D, Reshef, D, Goodman, S |
| Journal | J Gerontol A Biol Sci Med Sci |
| Volume | 66 |
| Issue | 1 |
| Pagination | 74-81 |
| Date Published | 2011 Jan |
| ISSN | 1758-535X |
| Keywords | Aged, Aged, 80 and over, Brain, Brain Ischemia, Cerebrovascular Circulation, Diastole, Female, Humans, Incidence, Male, Multivariate Analysis, Stroke |
| Abstract | <p><b>BACKGROUND: </b>The optimal blood pressure level to minimize the risk of ischemic stroke (IS) in older adults is undetermined. Cerebral white matter lesions (WML), prevalent in older adults, may be a marker for vulnerability to IS. We aimed at determining the relationship between diastolic blood pressure (DBP) levels and IS in the presence of WML.</p><p><b>METHODS: </b>The Cardiovascular Health Study population (N = 3,345, age ≥ 65 years, N = 3,345) was followed between 1989 and 2002 for IS incidence. Survival analysis included quintiles of DBP analyzed within WML levels controlling for age and cardiovascular disease.</p><p><b>RESULTS: </b>DBP had no effect on IS incidence in low WML levels but had a marginally significant J-curve relationship with IS in high WML levels: the adjusted hazard ratio for IS in the lowest (<63 mmHg) and highest (≥ 80) DBP quintiles compared with the third (nadir, 69-73 mmHg) was 1.64 (95% confidence interval: 0.93-2.9) and 1.83 (95% confidence interval: 1.06-3.15), respectively.</p><p><b>CONCLUSIONS: </b>In older adults with low-grade WML, low DBP may not pose a risk for IS. However, in high-grade WML, IS risk may increase in DBP less than 69 mmHg but is highest more than 80 mmHg. People with high-grade WML may be at risk of IS in high and low DBP.</p> |
| DOI | 10.1093/gerona/glq166 |
| Alternate Journal | J. Gerontol. A Biol. Sci. Med. Sci. |
| PubMed ID | 21030465 |
| PubMed Central ID | PMC3032431 |
| Grant List | N01-HC-85085 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01 HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-45133 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States |