Cerebral Vasomotor Reactivity and Extent of White Matter Lesions in Middle-Aged Men With Arterial Hypertension: A Pilot Study
Background Cerebrovascular reactivity (CVR) impairment and cerebral white matter lesions (WMLs) are associated in elderly or patients with overt cerebral ischemia. Such association has not been confirmed for asymptomatic middle-aged individuals with risk factors for stroke. We assessed the relations...
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| Veröffentlicht in: | American journal of hypertension 2010-11, Vol.23 (11), p.1198-1203 |
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| creator | Kozera, Grzegorz M. Dubaniewicz, Mirosława Zdrojewski, Tomasz Madej-Dmochowska, Aleksandra Mielczarek, Milena Wojczal, Joanna Chwojnicki, Kamil świerblewska, Ewa Schminke, Ulf Wyrzykowski, Bogdan Nyka, Walenty M. |
| description | Background Cerebrovascular reactivity (CVR) impairment and cerebral white matter lesions (WMLs) are associated in elderly or patients with overt cerebral ischemia. Such association has not been confirmed for asymptomatic middle-aged individuals with risk factors for stroke. We assessed the relationship between the CVR and the presence of WMLs in a middle-aged population-based cohort of hypertensive men. Methods Magnetic resonance imaging (MRI) and transcranial Doppler (TCD) examination were performed in 54 hypertensive men, all at 60 years of age, without a history of stroke, neurologic deficits, or carotid stenosis. The CVR of the middle cerebral artery (MCA) was expressed as the vasomotor reactivity reserve (VMRr). Results WMLs were detected in 22 men (40.7%); all WMLs were classified as mild (first grade of the Fazekas modified scale). The VMRr was lower in patients with WMLs (mean 55%; s.e. 3%) compared to those without WMLs (mean 65%; s.e. 3%; P = 0.03). The lower VMRr in patients with WMLs was consistent after controlling for confounders. A higher pulsatility index (PI) in subjects with WMLs (mean 1.08; s.e. 0.05) compared to those without WMLs (mean 0.90; s.e. 0.05; P = 0.01) was not consistent after controlling for confounders. Conclusions The CVR was lower in middle-aged hypertensive men with WMLs compared to those without WMLs indicating that even a low load of WMLs may reflect some functional impairment of the cerebral microvasculature. |
| doi_str_mv | 10.1038/ajh.2010.152 |
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Such association has not been confirmed for asymptomatic middle-aged individuals with risk factors for stroke. We assessed the relationship between the CVR and the presence of WMLs in a middle-aged population-based cohort of hypertensive men. Methods Magnetic resonance imaging (MRI) and transcranial Doppler (TCD) examination were performed in 54 hypertensive men, all at 60 years of age, without a history of stroke, neurologic deficits, or carotid stenosis. The CVR of the middle cerebral artery (MCA) was expressed as the vasomotor reactivity reserve (VMRr). Results WMLs were detected in 22 men (40.7%); all WMLs were classified as mild (first grade of the Fazekas modified scale). The VMRr was lower in patients with WMLs (mean 55%; s.e. 3%) compared to those without WMLs (mean 65%; s.e. 3%; P = 0.03). The lower VMRr in patients with WMLs was consistent after controlling for confounders. A higher pulsatility index (PI) in subjects with WMLs (mean 1.08; s.e. 0.05) compared to those without WMLs (mean 0.90; s.e. 0.05; P = 0.01) was not consistent after controlling for confounders. Conclusions The CVR was lower in middle-aged hypertensive men with WMLs compared to those without WMLs indicating that even a low load of WMLs may reflect some functional impairment of the cerebral microvasculature.</description><identifier>ISSN: 0895-7061</identifier><identifier>EISSN: 1941-7225</identifier><identifier>EISSN: 1879-1905</identifier><identifier>DOI: 10.1038/ajh.2010.152</identifier><identifier>PMID: 20651697</identifier><identifier>CODEN: AJHYE6</identifier><language>eng</language><publisher>Basingstoke: Oxford University Press</publisher><subject>arterial hypertension ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; blood pressure ; Brain Ischemia - diagnosis ; Brain Ischemia - epidemiology ; Brain Ischemia - physiopathology ; Cardiology. Vascular system ; Cerebrovascular Circulation - physiology ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Female ; Humans ; hypertension ; Hypertension - diagnosis ; Hypertension - epidemiology ; Hypertension - physiopathology ; Leukoencephalopathies - diagnosis ; Leukoencephalopathies - epidemiology ; Leukoencephalopathies - physiopathology ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Microcirculation - physiology ; Middle Aged ; Middle Cerebral Artery - diagnostic imaging ; Middle Cerebral Artery - pathology ; Middle Cerebral Artery - physiopathology ; Pilot Projects ; Risk Factors ; Severity of Illness Index ; transcranial Doppler ; Ultrasonography, Doppler, Transcranial ; vasomotor reactivity ; Vasomotor System - diagnostic imaging ; Vasomotor System - pathology ; Vasomotor System - physiopathology ; white matter lesions</subject><ispartof>American journal of hypertension, 2010-11, Vol.23 (11), p.1198-1203</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Nov 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-77f6ddb8629b80a141f48b6d777195c0220d0ef1bc6799d37765a95418c734013</citedby><cites>FETCH-LOGICAL-c424t-77f6ddb8629b80a141f48b6d777195c0220d0ef1bc6799d37765a95418c734013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23384033$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20651697$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kozera, Grzegorz M.</creatorcontrib><creatorcontrib>Dubaniewicz, Mirosława</creatorcontrib><creatorcontrib>Zdrojewski, Tomasz</creatorcontrib><creatorcontrib>Madej-Dmochowska, Aleksandra</creatorcontrib><creatorcontrib>Mielczarek, Milena</creatorcontrib><creatorcontrib>Wojczal, Joanna</creatorcontrib><creatorcontrib>Chwojnicki, Kamil</creatorcontrib><creatorcontrib>świerblewska, Ewa</creatorcontrib><creatorcontrib>Schminke, Ulf</creatorcontrib><creatorcontrib>Wyrzykowski, Bogdan</creatorcontrib><creatorcontrib>Nyka, Walenty M.</creatorcontrib><creatorcontrib>SOPKARD Study Group</creatorcontrib><title>Cerebral Vasomotor Reactivity and Extent of White Matter Lesions in Middle-Aged Men With Arterial Hypertension: A Pilot Study</title><title>American journal of hypertension</title><addtitle>AJH</addtitle><description>Background Cerebrovascular reactivity (CVR) impairment and cerebral white matter lesions (WMLs) are associated in elderly or patients with overt cerebral ischemia. Such association has not been confirmed for asymptomatic middle-aged individuals with risk factors for stroke. We assessed the relationship between the CVR and the presence of WMLs in a middle-aged population-based cohort of hypertensive men. Methods Magnetic resonance imaging (MRI) and transcranial Doppler (TCD) examination were performed in 54 hypertensive men, all at 60 years of age, without a history of stroke, neurologic deficits, or carotid stenosis. The CVR of the middle cerebral artery (MCA) was expressed as the vasomotor reactivity reserve (VMRr). Results WMLs were detected in 22 men (40.7%); all WMLs were classified as mild (first grade of the Fazekas modified scale). The VMRr was lower in patients with WMLs (mean 55%; s.e. 3%) compared to those without WMLs (mean 65%; s.e. 3%; P = 0.03). The lower VMRr in patients with WMLs was consistent after controlling for confounders. A higher pulsatility index (PI) in subjects with WMLs (mean 1.08; s.e. 0.05) compared to those without WMLs (mean 0.90; s.e. 0.05; P = 0.01) was not consistent after controlling for confounders. Conclusions The CVR was lower in middle-aged hypertensive men with WMLs compared to those without WMLs indicating that even a low load of WMLs may reflect some functional impairment of the cerebral microvasculature.</description><subject>arterial hypertension</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>blood pressure</subject><subject>Brain Ischemia - diagnosis</subject><subject>Brain Ischemia - epidemiology</subject><subject>Brain Ischemia - physiopathology</subject><subject>Cardiology. Vascular system</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>Female</subject><subject>Humans</subject><subject>hypertension</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Leukoencephalopathies - diagnosis</subject><subject>Leukoencephalopathies - epidemiology</subject><subject>Leukoencephalopathies - physiopathology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microcirculation - physiology</subject><subject>Middle Aged</subject><subject>Middle Cerebral Artery - diagnostic imaging</subject><subject>Middle Cerebral Artery - pathology</subject><subject>Middle Cerebral Artery - physiopathology</subject><subject>Pilot Projects</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>transcranial Doppler</subject><subject>Ultrasonography, Doppler, Transcranial</subject><subject>vasomotor reactivity</subject><subject>Vasomotor System - diagnostic imaging</subject><subject>Vasomotor System - pathology</subject><subject>Vasomotor System - physiopathology</subject><subject>white matter lesions</subject><issn>0895-7061</issn><issn>1941-7225</issn><issn>1879-1905</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpd0c2LEzEYBvAgiltXb54lIOLFWfOdyd5K2bVCi4tfFS8hM8nY1OmkJplle_B_N6V1BU95w_vj4YUHgOcYXWBE67dms74g6PDj5AGYYMVwJQnhD8EE1YpXEgl8Bp6ktEEIMSHwY3BGkOBYKDkBv2cuuiaaHn41KWxDDhF-dKbN_tbnPTSDhVd32Q0Zhg6u1j47uDQ5uwgXLvkwJOgHuPTW9q6a_nAWLt0AVz6v4TQW5UvwfL9zZR4O_BJO4Y3vQ4af8mj3T8GjzvTJPTu95-DL9dXn2bxafHj3fjZdVC0jLFdSdsLaphZENTUymOGO1Y2wUkqseIsIQRa5DjetkEpZKqXgRnGG61ZShjA9B6-PubsYfo0uZb31qXV9bwYXxqQlV5QwyWSRL_-TmzDGoRynMSKM10qyuqg3R9XGkFJ0nd5FvzVxX5A-tKJLK_rQii6tFP7iFDo2W2fv8d8aCnh1Aia1pu-iGVqf_jlKa4YoLa46Op-yu7vfm_hTC0kl1_Nv3_XNirOloDPN6B8inKJK</recordid><startdate>20101101</startdate><enddate>20101101</enddate><creator>Kozera, Grzegorz M.</creator><creator>Dubaniewicz, Mirosława</creator><creator>Zdrojewski, Tomasz</creator><creator>Madej-Dmochowska, Aleksandra</creator><creator>Mielczarek, Milena</creator><creator>Wojczal, Joanna</creator><creator>Chwojnicki, Kamil</creator><creator>świerblewska, Ewa</creator><creator>Schminke, Ulf</creator><creator>Wyrzykowski, Bogdan</creator><creator>Nyka, Walenty M.</creator><general>Oxford University Press</general><general>Nature Publishing Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20101101</creationdate><title>Cerebral Vasomotor Reactivity and Extent of White Matter Lesions in Middle-Aged Men With Arterial Hypertension: A Pilot Study</title><author>Kozera, Grzegorz M. ; Dubaniewicz, Mirosława ; Zdrojewski, Tomasz ; Madej-Dmochowska, Aleksandra ; Mielczarek, Milena ; Wojczal, Joanna ; Chwojnicki, Kamil ; świerblewska, Ewa ; Schminke, Ulf ; Wyrzykowski, Bogdan ; Nyka, Walenty M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-77f6ddb8629b80a141f48b6d777195c0220d0ef1bc6799d37765a95418c734013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>arterial hypertension</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>blood pressure</topic><topic>Brain Ischemia - diagnosis</topic><topic>Brain Ischemia - epidemiology</topic><topic>Brain Ischemia - physiopathology</topic><topic>Cardiology. Vascular system</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Female</topic><topic>Humans</topic><topic>hypertension</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Leukoencephalopathies - diagnosis</topic><topic>Leukoencephalopathies - epidemiology</topic><topic>Leukoencephalopathies - physiopathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microcirculation - physiology</topic><topic>Middle Aged</topic><topic>Middle Cerebral Artery - diagnostic imaging</topic><topic>Middle Cerebral Artery - pathology</topic><topic>Middle Cerebral Artery - physiopathology</topic><topic>Pilot Projects</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>transcranial Doppler</topic><topic>Ultrasonography, Doppler, Transcranial</topic><topic>vasomotor reactivity</topic><topic>Vasomotor System - diagnostic imaging</topic><topic>Vasomotor System - pathology</topic><topic>Vasomotor System - physiopathology</topic><topic>white matter lesions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kozera, Grzegorz M.</creatorcontrib><creatorcontrib>Dubaniewicz, Mirosława</creatorcontrib><creatorcontrib>Zdrojewski, Tomasz</creatorcontrib><creatorcontrib>Madej-Dmochowska, Aleksandra</creatorcontrib><creatorcontrib>Mielczarek, Milena</creatorcontrib><creatorcontrib>Wojczal, Joanna</creatorcontrib><creatorcontrib>Chwojnicki, Kamil</creatorcontrib><creatorcontrib>świerblewska, Ewa</creatorcontrib><creatorcontrib>Schminke, Ulf</creatorcontrib><creatorcontrib>Wyrzykowski, Bogdan</creatorcontrib><creatorcontrib>Nyka, Walenty M.</creatorcontrib><creatorcontrib>SOPKARD Study Group</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kozera, Grzegorz M.</au><au>Dubaniewicz, Mirosława</au><au>Zdrojewski, Tomasz</au><au>Madej-Dmochowska, Aleksandra</au><au>Mielczarek, Milena</au><au>Wojczal, Joanna</au><au>Chwojnicki, Kamil</au><au>świerblewska, Ewa</au><au>Schminke, Ulf</au><au>Wyrzykowski, Bogdan</au><au>Nyka, Walenty M.</au><aucorp>SOPKARD Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral Vasomotor Reactivity and Extent of White Matter Lesions in Middle-Aged Men With Arterial Hypertension: A Pilot Study</atitle><jtitle>American journal of hypertension</jtitle><addtitle>AJH</addtitle><date>2010-11-01</date><risdate>2010</risdate><volume>23</volume><issue>11</issue><spage>1198</spage><epage>1203</epage><pages>1198-1203</pages><issn>0895-7061</issn><eissn>1941-7225</eissn><eissn>1879-1905</eissn><coden>AJHYE6</coden><abstract>Background Cerebrovascular reactivity (CVR) impairment and cerebral white matter lesions (WMLs) are associated in elderly or patients with overt cerebral ischemia. Such association has not been confirmed for asymptomatic middle-aged individuals with risk factors for stroke. We assessed the relationship between the CVR and the presence of WMLs in a middle-aged population-based cohort of hypertensive men. Methods Magnetic resonance imaging (MRI) and transcranial Doppler (TCD) examination were performed in 54 hypertensive men, all at 60 years of age, without a history of stroke, neurologic deficits, or carotid stenosis. The CVR of the middle cerebral artery (MCA) was expressed as the vasomotor reactivity reserve (VMRr). Results WMLs were detected in 22 men (40.7%); all WMLs were classified as mild (first grade of the Fazekas modified scale). The VMRr was lower in patients with WMLs (mean 55%; s.e. 3%) compared to those without WMLs (mean 65%; s.e. 3%; P = 0.03). The lower VMRr in patients with WMLs was consistent after controlling for confounders. A higher pulsatility index (PI) in subjects with WMLs (mean 1.08; s.e. 0.05) compared to those without WMLs (mean 0.90; s.e. 0.05; P = 0.01) was not consistent after controlling for confounders. Conclusions The CVR was lower in middle-aged hypertensive men with WMLs compared to those without WMLs indicating that even a low load of WMLs may reflect some functional impairment of the cerebral microvasculature.</abstract><cop>Basingstoke</cop><pub>Oxford University Press</pub><pmid>20651697</pmid><doi>10.1038/ajh.2010.152</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | arterial hypertension Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels blood pressure Brain Ischemia - diagnosis Brain Ischemia - epidemiology Brain Ischemia - physiopathology Cardiology. Vascular system Cerebrovascular Circulation - physiology Clinical manifestations. Epidemiology. Investigative techniques. Etiology Female Humans hypertension Hypertension - diagnosis Hypertension - epidemiology Hypertension - physiopathology Leukoencephalopathies - diagnosis Leukoencephalopathies - epidemiology Leukoencephalopathies - physiopathology Magnetic Resonance Imaging Male Medical sciences Microcirculation - physiology Middle Aged Middle Cerebral Artery - diagnostic imaging Middle Cerebral Artery - pathology Middle Cerebral Artery - physiopathology Pilot Projects Risk Factors Severity of Illness Index transcranial Doppler Ultrasonography, Doppler, Transcranial vasomotor reactivity Vasomotor System - diagnostic imaging Vasomotor System - pathology Vasomotor System - physiopathology white matter lesions |
| title | Cerebral Vasomotor Reactivity and Extent of White Matter Lesions in Middle-Aged Men With Arterial Hypertension: A Pilot Study |
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