دورية أكاديمية
أعرض في EDS

Effect of the Blood Pressure and Antihypertensive Drugs on Cerebral Small Vessel Disease: A Mendelian Randomization Study.

التفاصيل البيبلوغرافية
العنوان: Effect of the Blood Pressure and Antihypertensive Drugs on Cerebral Small Vessel Disease: A Mendelian Randomization Study.
المؤلفون: Ma Y; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China., Wang M; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China., Chen X; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China., Yao J; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China., Ding Y; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China., Gao Q; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China., Zhou J; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China., Lian X; Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou, China.
المصدر: Stroke [Stroke] 2024 Jul; Vol. 55 (7), pp. 1838-1846. Date of Electronic Publication: 2024 May 31.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0235266 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4628 (Electronic) Linking ISSN: 00392499 NLM ISO Abbreviation: Stroke Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins
Original Publication: Dallas : American Heart Association
مواضيع طبية MeSH: Mendelian Randomization Analysis* , Cerebral Small Vessel Diseases*/genetics , Cerebral Small Vessel Diseases*/drug therapy , Cerebral Small Vessel Diseases*/diagnostic imaging , Antihypertensive Agents*/therapeutic use , Blood Pressure*/drug effects , Blood Pressure*/genetics , Genome-Wide Association Study* , Polymorphism, Single Nucleotide*, Humans ; Hypertension/drug therapy ; Hypertension/genetics ; Female ; Male ; Stroke, Lacunar/genetics ; Stroke, Lacunar/drug therapy ; Calcium Channel Blockers/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; White Matter/diagnostic imaging ; White Matter/pathology ; Middle Aged
مستخلص: Background: Previous studies yielded conflicting results about the influence of blood pressure (BP) and antihypertensive treatment on cerebral small vessel disease. Here, we conducted a Mendelian randomization study to investigate the effect of BP and antihypertensive drugs on cerebral small vessel disease.
Methods: We extracted single-nucleotide polymorphisms for systolic BP and diastolic BP from a genome-wide association study (N=757 601) and screened single-nucleotide polymorphisms associated with calcium channel blockers, thiazides, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and β-blockers from public resources as instrumental variables. Then, we chose the genome-wide association study of white matter hyperintensity (WMH; N=18 381), cerebral microbleed (3556 cases, 22 306 controls), white matter perivascular space (9317 cases, 29 281 controls), basal ganglia perivascular space (BGPVS; 8950 cases, 29 953 controls), hippocampal perivascular space (HIPPVS; 9163 cases, 29 708 controls), and lacunar stroke (6030 cases, 248 929 controls) as outcome data sets. Subsequently, we conducted a 2-sample Mendelian randomization analysis.
Results: We found that elevated systolic BP significantly increases the risk of BGPVS (odds ratio [OR], 1.05 [95% CI, 1.04-1.07]; P =1.72×10 -12 ), HIPPVS (OR, 1.04 [95% CI, 1.02-1.05]; P =2.71×10 -7 ), and lacunar stroke (OR, 1.41 [95% CI, 1.30-1.54]; P =4.97×10 -15 ). There was suggestive evidence indicating that elevated systolic BP is associated with higher WMH volume (β=0.061 [95% CI, 0.018-0.105]; P =5.58×10 -3 ) and leads to an increased risk of cerebral microbleed (OR, 1.16 [95% CI, 1.04-1.29]; P =7.17×10 -3 ). Elevated diastolic BP was significantly associated with higher WMH volume (β=0.087 [95% CI, 0.049-0.124]; P =5.23×10 -6 ) and significantly increased the risk of BGPVS (OR, 1.05 [95% CI, 1.04-1.06]; P =1.20×10 -16 ), HIPPVS (OR, 1.03 [95% CI, 1.02-1.04]; P =2.96×10 -6 ), and lacunar stroke (OR, 1.31 [95% CI, 1.21-1.41]; P =2.67×10 -12 ). The use of calcium channel blocker to lower BP was significantly associated with lower WMH volume (β=-0.287 [95% CI, -0.408 to -0.165]; P =4.05×10 -6 ) and significantly reduced the risk of BGPVS (OR, 0.85 [95% CI, 0.81-0.89]; P =8.41×10 -19 ) and HIPPVS (OR, 0.88 [95% CI, 0.85-0.92]; P =6.72×10 -9 ).
Conclusions: Our findings contribute to a better understanding of the pathogenesis of cerebral small vessel disease. Additionally, the utilization of calcium channel blockers to decrease BP can effectively reduce the likelihood of WMH, BGPVS, and HIPPVS. These findings offer valuable insights for the management and prevention of cerebral small vessel disease.
Competing Interests: Disclosures None.
فهرسة مساهمة: Keywords: antihypertensive agents; arteries; blood pressure; cerebral small vessel diseases; stroke
المشرفين على المادة: 0 (Antihypertensive Agents)
0 (Calcium Channel Blockers)
0 (Angiotensin-Converting Enzyme Inhibitors)
تواريخ الأحداث: Date Created: 20240531 Date Completed: 20240624 Latest Revision: 20240624
رمز التحديث: 20240625
DOI: 10.1161/STROKEAHA.123.045664
PMID: 38818733
قاعدة البيانات: MEDLINE
الوصف
تدمد:1524-4628
DOI:10.1161/STROKEAHA.123.045664