Relationships between blood pressure variability and silent cerebral infarction in patients with primary hypertension

Aims: This study aimed to investigate the relationship between blood pressure variability and the incidence of silent cerebral infarction (SCI) in patients with primary hypertension. Methods: The 346 hospitalized patients with primary hypertension were divided into primary hypertension group (160 cases) and primary hypertension combined with SCI group (186 cases). The 24-h ambulatory blood pressure was measured. Clinical data were collected. Univariate and multivariate logistic regression analysis was performed. Results: There were significant differences between patients with primary hypertension combined with SCI and patients with primary hypertension only in age, stroke history, diabetes history, smoking, alcohol consumption, FBG, Hcy, and Lp-PLA2. The 24-h ambulatory blood pressure monitoring results suggested that dSBP, dSSD, 24hSBP, nSSD, dDBP, dDSD, nDSD, 24hDSD, ddnSBP, and ddnDBP in patients with hypertension and SCI were higher than those in patients with primary hypertension only. Non-dipper blood pressure was more common. Multivariate logistic regression analysis showed dSSD (OR: 1.374, 95%CI [1.173-1.609]), 24 h DSD (OR: 1.194, 95%CI [1.017,1.402]), dSBP (OR: 1.062, 95%CI [1.022, 1.103]), age (OR: 1.042, 95%CI [1.005, 1.080]), smoking (OR: 2.610, 95%CI [1.495, 4.556]), fasting plasma glucose (OR: 1.183, 95%CI [1.040, 1.345]), and Lp-PLA2 (OR: 1.004, 95%CI [1.003, 1.006]) were positively correlated with SCI in hypertension patients. Conclusions: Blood pressure variability (dSSD and24hDSD) is independently associated with SCI in patients with primary hypertension. In addition, traditional risk factors, blood pressure level (dSBP), age, smoking, fasting plasma glucose, and Lp-PLA2 were also independently associated with SCI in patients with primary hypertension. (C) 2018 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.