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

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

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 monit...

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Autores principales: Naveed Akhtar, Salman Al-Jerdi, Saadat Kamran, Rajvir Singh, Blessy Babu, Mohamed S. Abdelmoneim, Deborah Morgan, Sujatha Joseph, Reny Francis, Ashfaq Shuaib
Formato: article
Lenguaje:EN
Publicado: Frontiers Media S.A. 2021
Materias:
ischemic stroke
night-time non-dipping
outcome
stroke types
stroke severity
small vessel disease
Neurology. Diseases of the nervous system
RC346-429
Acceso en línea:https://doaj.org/article/be4c1925154646978a1b17f0466e8be0
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spelling oai:doaj.org-article:be4c1925154646978a1b17f0466e8be02021-11-16T13:47:13ZNight-Time Non-dipping Blood Pressure and Heart Rate: An Association With the Risk of Silent Small Vessel Disease in Patients Presenting With Acute Ischemic Stroke1664-229510.3389/fneur.2021.719311https://doaj.org/article/be4c1925154646978a1b17f0466e8be02021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.719311/fullhttps://doaj.org/toc/1664-2295Background 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.Naveed AkhtarSalman Al-JerdiSaadat KamranRajvir SinghBlessy BabuMohamed S. AbdelmoneimDeborah MorganSujatha JosephReny FrancisAshfaq ShuaibFrontiers Media S.A.articleischemic strokenight-time non-dippingoutcomestroke typesstroke severitysmall vessel diseaseNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution DOAJ
collection DOAJ
language EN
topic ischemic stroke
night-time non-dipping
outcome
stroke types
stroke severity
small vessel disease
Neurology. Diseases of the nervous system
RC346-429
spellingShingle ischemic stroke
night-time non-dipping
outcome
stroke types
stroke severity
small vessel disease
Neurology. Diseases of the nervous system
RC346-429
Naveed Akhtar
Salman Al-Jerdi
Saadat Kamran
Rajvir Singh
Blessy Babu
Mohamed S. Abdelmoneim
Deborah Morgan
Sujatha Joseph
Reny Francis
Ashfaq Shuaib
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
description 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.
format article
author Naveed Akhtar
Salman Al-Jerdi
Saadat Kamran
Rajvir Singh
Blessy Babu
Mohamed S. Abdelmoneim
Deborah Morgan
Sujatha Joseph
Reny Francis
Ashfaq Shuaib
author_facet Naveed Akhtar
Salman Al-Jerdi
Saadat Kamran
Rajvir Singh
Blessy Babu
Mohamed S. Abdelmoneim
Deborah Morgan
Sujatha Joseph
Reny Francis
Ashfaq Shuaib
author_sort Naveed Akhtar
title 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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/be4c1925154646978a1b17f0466e8be0
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