on February 1, 2007
Published online before print February 1, 2007, doi: 10.1161/01.ATV.0000258947.17570.38
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Submitted on December 4, 2006
Accepted on December 21, 2006
Plasma Fibrinogen, Ambulatory Blood Pressure, and Silent Cerebrovascular Lesions. The Ohasama Study
Yoko Aono ;
From the Departments of Clinical Pharmacology and Therapeutics (Y.A., M.K., A.H., T.O., H.M., Y.S., K.T., Y.I.), Planning for Drug Development and Clinical Evaluation (T.O., K.A., J.H.), Environmental health Sciences (H.S.), and Physical Medicine and Rehabilitation (T.K., S.I.), Tohoku University Graduate School of Pharmaceutical Sciences and Medicine; Tohoku University 21st Century COE Program "Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation" (T.O., A.H., T.O., H.M., R.I., J.H., K.T., H.S., Y.I.), Sendai, Japan; Ohasama Hospital (H.H.), Iwate, Japan.
* To whom correspondence should be addressed. E-mail: tohkubo{at}mail.tains.tohoku.ac.jp.
Objective--Twenty-four-hour ambulatory blood pressure (24-hour ABP) values are considered a powerful predictor of stroke. Silent cerebrovascular lesions are associated with an increased risk of stroke. Because fibrinogen is a major determinant of plasma viscosity, an elevated fibrinogen level might also be associated with stroke risk. We evaluated the association of 24-hour ABP and plasma fibrinogen levels with the risk of silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected by MRI.
Methods and Results--The study cohort comprised 958 individuals from the general population of Ohasama, a rural Japanese community. Multiple logistic regression analysis adjusted for age, sex, smoking and drinking status, use of antihypertensive medication, body mass index, 24-hour ABP, and a history of hypercholesterolemia, diabetes mellitus, and atrial fibrillation demonstrated that each 1-SD increase in fibrinogen level was associated with a significantly increased risk of silent cerebrovascular lesions (odds ratio, 1.26; P=0.001). The 24-hour ABP was also significantly and independently associated with the risk of silent cerebrovascular lesions. Even when 24-hour ABP values were within normal range (<135/80 mm Hg), elevated fibrinogen levels were associated with an increased risk of silent cerebrovascular lesions. Fibrinogen and 24-hour BP had additive effects on silent cerebrovascular lesions.
Conclusion--The 24-hour ABP and plasma fibrinogen levels were closely and independently associated with the risk of silent cerebrovascular lesions including white matter hyperintensity and lacunar infarct.
Key words: ambulatory blood pressure • lacunar infarct • plasma fibrinogen • silent cerebrovascular lesions • white matter hyperintensity
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