Association of arterial stiffness and blood pressure variability with silent brain lesions in healthy hypertensive elderly Chinese
Notice bibliographique
Résumé
Silent brain lesions (SBLs) are frequently detected in elderly subjects with hypertension. Although without apparent stroke symptoms, they are related to high risks of stroke and dementia. Arterial stiffness and visit-to-visit blood pressure variability (BPV) are two non-invasive clinical indicators that are associated with increased risks of stroke and other cardiovascular events. However, the associations of them with SBLs and cognitive function in elderly hypertensive subjects are still unclear. \n \nThis thesis was aimed to 1) investigate the prevalence and risk factors of SBLs; 2) to study the associations of arterial stiffness with SBLs and cognitive impairment; and 3) to evaluate the associations of visit-to-visit-BPV with SBLs and cognitive impairment in generally healthy hypertensive elderly Chinese. Elderly Chinese subjects were recruited from the general out-patient clinic if they had a history of hypertension for ≥ 5 years and no history of stroke, dementia or cardiovascular diseases. All subjects underwent a 3.0 T magnetic resonance imaging examination of the brain. Four types of SBLs were rated, including silent brain infarcts (SBIs), brain microbleeds (BMBs), periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH). Cognitive impairment was assessed by the Montreal Cognitive Assessment (MoCA) scale. Brachial-ankle pulse wave velocity (baPWV), a valid indicator of arterial stiffness, was measured using the Omron PWV / ABI device. Previous office blood pressure measurements were collected for the calculation of visit-to-visit BPV parameters, which included the standard deviation, coefficient of variation, successive variation and variation independent of mean blood pressure. \n \nAmong 349 patients, 16.3 % had SBIs, 22.9 % had BMBs, 8.6 % had severe PVH and 4.0 % had severe DWMH. The following associations between clinical factors and SBL subtypes were found to be significant in statistical analyses: 1) smoking, high pulse pressure and low fasting glucose with SBIs; 2) high pulse pressure and high-density lipoprotein cholesterol with BMBs; 3) age with the severity of PVH and DWMH. Age, pulse pressure, PVH and lobar BMBs were significantly associated with cognitive impairment. \n \nbaPWV predicted severe PVH independent of age and blood pressure levels. The highest quartile of baPWV was associated with a 2.5- to 3-fold increased risk of severe PVH. No significant association was found between baPWV and other SBLs. High baPWV was significantly related to cognitive impairment. Systolic BPV and pulse pressure variability were predictive of the severity of PVH. Systolic BPV were associated with the severity of DWMH. No significant relationship was found between BPV and other SBLs. Pulse pressure variability was significantly higher in those presented with cognitive impairment. In addition, baPWV and systolic BPV were significantly correlated with each other. \nIn summary, this thesis provided evidences regarding the prevalence of SBLs, and the predictive value of arterial stiffness and visit-to-visit BPV for SBLs and cognitive impairment. Arterial stiffness and visit-to-visit BPV may serve as useful clinical measurements for the prediction of severe white matter hyperintensity in healthy hypertensive elderly Chinese.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».