HYPERTENSION AND DIABETES-MELLITUS AS DETERMINANTS OF MULTIPLE LACUNAR INFARCTS

被引:117
作者
MAST, H
THOMPSON, JLP
LEE, SH
MOHR, JP
SACCO, RL
机构
[1] COLUMBIA PRESBYTERIAN MED CTR,IRVING CTR CLIN RES,NEW YORK,NY 10032
[2] COLUMBIA PRESBYTERIAN MED CTR,DIV EPIDEMIOL,NEW YORK,NY 10032
[3] COLUMBIA PRESBYTERIAN MED CTR,GERTRUDE H SERGIEVSKY CTR,COLUMBIA UNIV SCH PUBL HLTH,NEW YORK,NY 10032
关键词
HYPERTENSION; DIABETES MELLITUS; LACUNES;
D O I
10.1161/01.STR.26.1.30
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose We investigated the relationship between hypertension, diabetes mellitus, and lacunes. Methods From 1237 cases of ischemic stroke in the Stroke Data Bank of the National Institute of Neurological and Communicative Disorders and Stroke, data from 637 patients whose initial computed tomograms showed lacunar (n=184) or nonlacunar infarcts (n=453) were analyzed. The group with lacunar infarcts was further divided into subgroups according to whether the patients had multiple (n=40) or single (n=144) lacunar infarcts. The association of hypertension and diabetes mellitus with lacunar infarcts was investigated using logistic regression models that included age, sex, and cardiac disease. Similar models were used to analyze the effects of diastolic and systolic blood pressure. Results Hypertension (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.1 to 6.0) and diabetes (OR, 2.3; 95% CI, 1.1 to 45) were significantly related to multiple but not to single lacunes. Cardiac disease was inversely associated with both single and multiple lacunes. Diastolic brood pressure significantly affected the probability of multiple lacunar infarcts (OR, 1.4; 95% CI, 1.04 to 1.9), whereas systolic pressure did not. Conclusions There may be etiologically distinct lacunar infarct subgroups, with multiple lacunes being strongly related to hypertension and diabetes mellitus. Other stroke risk factors may be more important in patients with single lacunes. Diastolic rather than systolic pressure seems to be a major determinant of multiple lacunes.
引用
收藏
页码:30 / 33
页数:4
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