The structural and functional consequences of diurnal variations in blood pressure in treated patients with hypertensive cerebrovascular disease
Bibliographic record
Abstract
BACKGROUND: Although hypertension is known to cause brain damage and cognitive impairment, epidemiological studies suggest that lower blood pressure (BP) in patients with established cerebrovascular disease is associated with more rapid cognitive decline. We investigated the relationship between 24-h ambulatory blood pressure (ABP) measurements, cerebrovascular disease load and cognitive performance in patients with hypertensive cerebrovascular disease. METHODS: Eighty-eight patients (mean age 65+9 years) with hypertensive cerebrovascular disease on MRI were recruited. BP was controlled optimally. ABP monitoring, quantitative MRI analysis of white matter lesion (WML) volume and executive cognitive function tests were performed. The relationships between ABP variables, WML volume and executive test performance were examined using regression analyses to adjust for age, sex, vascular risk profile and premorbid intelligence. RESULTS: Patients had a mean daytime ABP of 96+10 mmHg and mean night-time ABP of 88+11 mmHg (P = 0.001). Median WML volume was 8464 mm3. There were no significant associations between ABP variables and supratentorial WML volumes. Infratentorial WML volume correlated negatively with night-time mean BP (r = -0.6, P = 0.002) and positively with nocturnal dipping (r = 0.6, P = 0.002). Higher night-time mean BP was an independent predictor of reduced infratentorial WML volume (R2: 0.460, P = 0.008).Infratentorial WML volume correlated with impairments of phonemic verbal fluency (r = 0.5, P < 0.001) and choice reaction time (r = 0.7, P < 0.005). CONCLUSION: Physiological falls in nocturnal BP may be associated with increased infratentorial WML volume and cognitive dysfunction in optimally controlled hypertensive patients with cerebrovascular disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".