J Korean Neurol Assoc.  1996 Dec;14(4):921-929.

24-hour Blood Pressure Monitoring in Chronic Cerebrovascular Disease: Decreased Nocturnal Blood Pressure Dip

• Jung S
• Lee BC
• Yu KH
• Jung SC
• Kim SM
• Kwon KH
• Whang SH

Abstract

BACKGROUND: Periventricular white matter changes(PVWC) in chronic cerebrovascular disease are regarded to be caused by chronic low perfusion and as forms of small arterial disease of cerebral circulation. In some reports, these are suggested to be concerned with the fluctuation of blood pressure. The purpose of this study was to elucidate the diurnal pattern of BP in chronic cerebrovascular disease and the relationship between severity of PVWC and decrement of nocturnal dip through the ambulatory 24 hour blood pressure monitoring (ABPM). Subjects and
METHODS
ABPM were carried out every 30 minutes in 36 patients with chronic cerebrovascular disease, prospectively. Twenty-five had PVWCS and/or multiple lacunar infarction (MLI) with various grades, 11 had large artery territorial infarction (LATI) without PVWC. The patterns of ABPM in each group were analyzed by disease entity and severity of PVWC.
RESULTS
There was no differences in the two groups; PVWC/MLl and LATI, in properties(age, sex, etc.) and possible stroke risk factors (hypertension, diabetes mellitus, hypercholesterolemia, smoking, etc.) (P<.05). The pattern of ABPM of PVWC/MLl group showed the decrement of nocturnal dip of BP unlike LATI group (P<.05). The decrement of nocturnal dip of BP correlated with severity of PVWC (P<.05).
CONCLUSION
We conclude that the diurnal pattern of BP in small artery disease is different from that of large arterial disease group and related to the severity of PVWC.

MeSH Terms

Arteries
Blood Pressure Monitors*
Blood Pressure*
Diabetes Mellitus
Humans
Hypercholesterolemia
Infarction
Perfusion
Prospective Studies
Risk Factors
Smoke
Smoking
Stroke
Stroke, Lacunar
Smoke