Extent of Cerebral White Matter Lesions Is Related to Changes of Circadian Blood Pressure Rhythmicity

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Abstract
WHITE MATTER lesions (WML) are frequently found on magnetic resonance imaging (MRI) scans of elderly patients and are associated with cardiovascular risk factors1-3; impaired cognitive functions, in particular a declined attention and speed of mental processing3-5; and an increased risk for the subsequent development of strokes.6 The pathogenesis, clinical significance, and morphologic substrate of these changes are incompletely understood. The frequency of WML increases with age,4,5,7 but an increased risk of WML has also been associated with arterial hypertension and heart disease.8-10 However, the pathogenic role of elevated blood pressure for the development and extent of WML has not unequivocally clarified so far. Previous investigations found hypertension to be either associated or not associated with WML, depending on whether a univariate or multivariate approach was used.9-13 In contrast to these observations, a significant relationship between arterial hypotension and WML has been recently described.14