| Diastolic blood pressure levels and ischemic stroke incidence in older adults with white matter lesions. | |
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MedLine Citation:
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PMID: 21030465 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The optimal blood pressure level to minimize the risk of ischemic stroke (IS) in older adults is undetermined. Cerebral white matter lesions (WML), prevalent in older adults, may be a marker for vulnerability to IS. We aimed at determining the relationship between diastolic blood pressure (DBP) levels and IS in the presence of WML. METHODS: The Cardiovascular Health Study population (N = 3,345, age ≥ 65 years, N = 3,345) was followed between 1989 and 2002 for IS incidence. Survival analysis included quintiles of DBP analyzed within WML levels controlling for age and cardiovascular disease. RESULTS: DBP had no effect on IS incidence in low WML levels but had a marginally significant J-curve relationship with IS in high WML levels: the adjusted hazard ratio for IS in the lowest (<63 mmHg) and highest (≥ 80) DBP quintiles compared with the third (nadir, 69-73 mmHg) was 1.64 (95% confidence interval: 0.93-2.9) and 1.83 (95% confidence interval: 1.06-3.15), respectively. CONCLUSIONS: In older adults with low-grade WML, low DBP may not pose a risk for IS. However, in high-grade WML, IS risk may increase in DBP less than 69 mmHg but is highest more than 80 mmHg. People with high-grade WML may be at risk of IS in high and low DBP. |
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Authors:
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Shoshana Reshef; Linda Fried; Norman Beauchamp; Daniel Scharfstein; Daniel Reshef; Steven Goodman |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-10-28 |
Journal Detail:
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Title: The journals of gerontology. Series A, Biological sciences and medical sciences Volume: 66 ISSN: 1758-535X ISO Abbreviation: J. Gerontol. A Biol. Sci. Med. Sci. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-27 Completed Date: 2011-01-31 Revised Date: 2012-01-02 |
Medline Journal Info:
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Nlm Unique ID: 9502837 Medline TA: J Gerontol A Biol Sci Med Sci Country: United States |
Other Details:
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Languages: eng Pagination: 74-81 Citation Subset: AIM; IM |
Affiliation:
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Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. sbreshef@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Brain / pathology* Brain Ischemia / epidemiology*, etiology Cerebrovascular Circulation* Diastole* Female Humans Incidence Male Multivariate Analysis Stroke / epidemiology*, etiology |
| Grant Support | |
ID/Acronym/Agency:
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N01 HC-15103/HC/NHLBI NIH HHS; N01 HC-55222/HC/NHLBI NIH HHS; N01-HC-35129/HC/NHLBI NIH HHS; N01-HC-45133/HC/NHLBI NIH HHS; N01-HC-75150/HC/NHLBI NIH HHS; N01-HC-85079/HC/NHLBI NIH HHS; N01-HC-85080/HC/NHLBI NIH HHS; N01-HC-85081/HC/NHLBI NIH HHS; N01-HC-85082/HC/NHLBI NIH HHS; N01-HC-85083/HC/NHLBI NIH HHS; N01-HC-85084/HC/NHLBI NIH HHS; N01-HC-85085/HC/NHLBI NIH HHS; N01-HC-85086/HC/NHLBI NIH HHS; U01 HL080295/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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