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Association of ambulatory blood pressure with ischemic brain injury
Schwartz GL, Bailey KR, Mosley T, Knopman DS, Jack CR, Canzanello VJ, Turner ST.. Hypertension (Dallas, Tex. : 1979), 2007-04-02
Topic: Risk, prevention and care in population studies
Cerebral white matter hyperintensities on brain MRI (leukoaraiosis) are associated with increased risk of stroke and dementia. To assess the relationships of blood pressure level and circadian pattern with leukoaraiosis, we obtained 24-hour ambulatory blood pressure recordings and brain magnetic resonance images in 343 white and 267 black adults who were members of sibships that had >or=2 siblings with essential hypertension. In multiple linear regression models, factors associated with greater leukoaraiosis in both racial groups included age (P<or=0.002), homocysteine levels (P<or=0.006), and brain volume (P<or=0.008). In blacks, ambulatory blood pressure measures associated with greater leukoaraiosis were higher awake, asleep, and 24-hour systolic and diastolic levels (P<or=0.009 for each). In addition, there was a trend for smaller nocturnal declines in systolic and diastolic levels (ie, nondipping patterns) to be associated with greater leukoaraiosis, and all of these associations, except nondipping of diastolic level, remained or became significant after controlling for office blood pressure (P<0.05 for each). In whites, among ambulatory blood pressure measures, only higher asleep diastolic levels trended toward association with greater leukoaraiosis. However, similar to findings in blacks, nondipping of systolic and diastolic ambulatory blood pressure levels were each associated with greater leukoaraiosis (P<or=0.008), and all of these associations remained or became significant after controlling for office blood pressure (P<or=0.009 for each). Higher ambulatory blood pressure levels and a nondipping circadian pattern contribute to greater leukoaraiosis volume after controlling for office blood pressure.
Key findings
- Cerebral white matter hyperintensities on brain MRI (leukoaraiosis) are associated with increased risk of stroke and dementia.
- In multiple linear regression models, factors associated with greater leukoaraiosis in both racial groups included age (P<or=0.002), homocysteine levels (P<or=0.006), and brain volume (P<or=0.008).
- In blacks, ambulatory blood pressure measures associated with greater leukoaraiosis were higher awake, asleep, and 24-hour systolic and diastolic levels (P<or=0.009 for each).
- In addition, there was a trend for smaller nocturnal declines in systolic and diastolic levels (ie, nondipping patterns) to be associated with greater leukoaraiosis, and all of these associations, except nondipping of diastolic level, remained or became significant after controlling for office blood pressure (P<0.05 for each).
- However, similar to findings in blacks, nondipping of systolic and diastolic ambulatory blood pressure levels were each associated with greater leukoaraiosis (P<or=0.008), and all of these associations remained or became significant after controlling for office blood pressure (P<or=0.009 for each).
Why it matters
This study found that in black adults, higher ambulatory blood pressure levels were associated with greater leukoaraiosis, a brain MRI finding linked to increased risk of stroke and dementia. It is an observational study of blood pressure and brain injury, not a test of any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Effect sizeor=0.002; or=0.006; or=0.008
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Hypertension (Dallas, Tex. : 1979)) |
| Journal's citation record | 3 / 4 | Hypertension: journal h-index 369 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2007 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 85 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.0 citations a year over 21 year(s) since 2007 |
| Impact for its field and year | 3 / 6 | Cited 7.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Stephen T. Turner: h-index 78 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Mayo Clinic: institution h-index 1,606 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17404188) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 42 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Schwartz, G. L., Bailey, K. R., Mosley, T., Knopman, D. S., Jack, C. R., Canzanello, V. J., et al. (2007). Association of ambulatory blood pressure with ischemic brain injury. Hypertension (Dallas, Tex. : 1979). https://doi.org/10.1161/hypertensionaha.106.078691
Vancouver
Schwartz GL, Bailey KR, Mosley T, Knopman DS, Jack CR, Canzanello VJ, et al. Association of ambulatory blood pressure with ischemic brain injury. Hypertension (Dallas, Tex. : 1979). 2007. doi:10.1161/hypertensionaha.106.078691. PMID: 17404188.
BibTeX
@article{schwartz2007-17404188,
author = {Schwartz, G. L. and Bailey, K. R. and Mosley, T. and Knopman, D. S. and Jack, C. R. and Canzanello, V. J. and Turner, S. T.},
title = {{Association of ambulatory blood pressure with ischemic brain injury}},
journal = {Hypertension (Dallas, Tex. : 1979)},
year = {2007},
doi = {10.1161/hypertensionaha.106.078691},
pmid = {17404188},
url = {https://doi.org/10.1161/hypertensionaha.106.078691}
}
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