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London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 529 Figure 1. Scatter plots of WMLs volume and the hippocampus, amygdala and CGM volume Table 1. Logistic regression analysis of lower volumes of thehippocampus, amygdala and the corti-cal grey matter (CGM). Variables Lower hippocampal vo-lume Lower amygdala volume Lower CGM volume p OR (95%C.I.) p OR (95%C.I.) p OR (95%C.I.) Age 0.098 1.060 (0.989-1.135) 0.033 1.062 (1.005-1.123) <0.001 1.123 (1.055-1.195) Sex (male) 0.004 5.714 (1.754-18.519) -- -- 0.001 6.173 (2.105-18.182) Std. WMLs vo-lume 0.004 1.869 (1.226-2.849) 0.070 1.042 (0.997-1.090) 0.317 0.903 (0.740-1.103) Old infarcts volume 0.139 2.919 (0.706-12.074) -- -- 0.204 1.151 (0.926-1.431) History of smo-king 0.574 0.701 (0.220-2.230) -- -- 0.661 0.795 (0.285-2.217) CGM= cortical grey matter; Std. WMLs volume = Standardized white matter lesions volume; OR=odds ratio. 456 Small vessel stroke and white matter disease Relationship between advanced cerebral white matter lesions and parameters in ambulatory blood pressure monitoring H.S. Kwon1, W.H. Jho2, S.H. Kim3, H.T. Kim4, H.Y. Kim5, Y.B. Lee6, Y.S. Kim7 Hanyang University Hospital, Seoul, SOUTH KOREA1, Hanyang University Hospital, Seoul, SOUTH KOREA2, Hanyang University Hospital, Seoul, SOUTH KOREA3, Hanyang Universi-ty Hospital, Seoul, SOUTH KOREA4, Hanyang University Hospital, Seoul, SOUTH KOREA5, Gachon University Gil Medical Center, Incheon, SOUTH KOREA6, Hanyang University Hospital, Seoul, SOUTH KOREA7 Background: White matter lesions (WMLs) are a common finding in stroke patients. As hyperten-sion and other vascular risk factors may involved in pathogenesis of WMLs, many studies have been reported the association between WMLs and ambulatory blood pressure monitoring (ABPM) param-eters. But little are known with hypertensive ischemic stroke patients. In addition, association be-tween circadian pattern of BP parameters such as blood pressure variation, morning surge, nocturnal dipping and WMLs are unclear yet. Methods: From August 2007 to July 2011, a total 188 hyperten-sive patients who had first-ever ischemic stroke within one week were included. Patients with severe hypertension, secondary hypertension, life-threatening medical condition, night-shift working, use of intravenous recombinant tissue-plasminogen activator and inadequate data were excluded. ABPM was applied 1-2 weeks after the ictus. Advanced WMLs were defined as grade 2 and 3 in MRI ac-cording to Fazeka’s grading. The subjects were classified into two groups by the presence or absence of advanced WMLs and ABPM parameters were compared. Results: Eighty-one (43%) subjects had advanced WMLs. In univariate analysis, higher 24 hour, awake and sleep BP levels were continu-ously associated with advanced WMLs. In addition, increased 24 h pulse pressure and 24 h heart rate were associated with advanced WMLs. However, circadian pattern of BP were not associated with WMLs. After adjusting covariates, BP levels, 24 h pulse pressure (OR: 1.035, 95% CI: 1.003- 1.067) and 24 h heart rate (OR: 1.030, 95% CI: 1.000-1.061) were independently associated with advanced WMLs. (Table 1) Conclusion: Cerebral WMLs were associated with increased BP, pulse pressure and hear rate. Increased heart rate and pulse pressure may rise the stress of small vessel wall and increase reactive oxygen species. Beyond increased BP, pulse pressure and heart rate also deserve more attention in predicting WMLs. Table 1 Multiple logistic regression analysis of potential risk factors for advanced white matter lesi-ons Unadjusted OR Model 1 p Model 2 p 24 hr SBP 1.052 (1.027 - 1.077) 1.050 (1.025 - 1.076) < 0.001 24 hr heart rate 1.030 (0.999 - 1.061) 1.030 (0.998 - 1.062) 0.065 1.041 (1.006 - 1.078) 0.022 24h pulse pressure 1.051 (1.021 - 1.082) 1.045 (1.008 - 1.083) 0.017 p for multivariate models; SBP, systolic blood pressure Data are presented as odds ratios (95% confidence interval) Model 1: Adjusted for age, diabetes mellitus and anti-hypertensive use Model 2: Additionally adjusted for 24 hr BP


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