Night-Time Non-dipping Blood Pressure and Heart Rate: An Association With the Risk of Silent Small Vessel Disease in Patients Presenting With Acute Ischemic Stroke

Frontiers in Neurology

Ashfaq Shuaib¹  Blessy Babu²  Reny Francis²  Saadat Kamran²  Deborah Morgan²  Naveed Akhtar²  Sujatha Joseph²  Mohamed S. Abdelmoneim²  Rajvir Singh²  Salman Al-Jerdi³ 

[1] Neurology Division, Department of Medicine, University of Alberta, Edmonton, AB, Canada;The Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar;Weill Cornell Medicine, Doha, Qatar;

关键词: ischemic stroke;    night-time non-dipping;    outcome;    stroke types;    stroke severity;    small vessel disease;   

DOI  :  10.3389/fneur.2021.719311

来源: DOAJ

【 摘 要 】

Background and Purpose: Nocturnal non-dipping blood pressure and heart rate are associated with an increased risk of cardiovascular disease. The effects of such variance on cerebrovascular disease have not been well studied.Methods: The 24-h ambulatory blood pressure (ABPM) and heart rate were monitored with B-pro in patients with acute stroke within the initial week of hospital admission. The risk factor profiles, clinical presentation, imaging, and short-term prognosis were compared in nocturnal dippers and non-dippers (more than 10% nocturnal decrease) of blood pressure and heart rate.Results: We enrolled 234 patients in whom ABPM and MRI data were available. Heart rate data were available in 180 patients. Lacunar sub-cortical stroke was the most common acute lesion (58.9%), while hypertension (74%) and diabetes (41.5%) were the most common associated risk factors. ABPM revealed non-dipping in 69% of patients. On univariate analysis, Small Vessel Disease (SVD) was significantly more frequent in non-dippers vs. dippers (BP: 56.8 vs. 40.3% p = 0.02; heart rate: 57.9 vs. 40.7% p = 0.03). Silent strokes were also more frequent in non-dippers vs. dippers (BP: 40.7 vs. 26.4% p = 0.35; heart rate: 44.6 vs. 25.4% p = 0.01). Multivariate analysis revealed SVD to be significantly related to age, hypertension, blood pressure non-dipping, and severity of symptoms at index event.Conclusions: The presence of nocturnal non-dipping of blood pressure and heart rate are associated with an increased risk of silent stroke and SVD. Increased use of ABPM may allow for improved diagnosis of non-dippers.

【 授权许可】

Unknown