Background/Aims: Pathogenetic mechanisms involved in enlargement of basal ganglia perivascular spaces (BG-PVSs) are controversial. Here, we assessed whether pulsatile or steady components of blood pressure (BP) are associated with enlarged BG-PVS. Methods: We evaluated the association between BG-PVS and pulsatile and steady components of BP in Atahualpa residents aged ≥60 years, by the use of regression models and receiver operator characteristics (ROC) curve analysis, after taking into account the effect of demographics, cardiovascular risk factors, and other signatures of cerebral small vessel disease (SVD). Results: Of 437 candidates, 363 (83%) were included. MRI showed >10 enlarged BG-PVS in 103 (28%) subjects. In univariate analysis, the association between enlarged BG-PVS and systolic pressure (SP) and pulse pressure (PP) were highly significant, while the association with diastolic pressure (DP) was not. ROC curve analysis showed a higher area under the curve for PP than for DP (p < 0.05). The area under the curve for SP was also higher than that of DP, but not significantly better due to overlapping 95% CI. Conclusion: Enlarged BG-PVS are associated with pulsatile components of BP, although some of the effect is taken away by the strong interaction between BG-PVS and other signatures of SVD.

1.
Doubal FN, MacLullich AM, Ferguson KJ, Dennis MS, Wardlaw JM: Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease. Stroke 2010; 41: 450–454.
2.
Zhu YC, Tzourio C, Soumaré A, Mazoyer B, Dufouil C, Chabriat H: Severity of dilated Virchow-Robin spaces is associated with age, blood pressure, and MRI markers of small vessel disease. A population-based study. Stroke 2010; 41: 2483–2490.
3.
Weller RO, Kida S, Zhang ET: Pathways of fluid drainage from the brain – morphological aspects and immunological significance in rat and man. Brain Pathol 1992; 2: 277–284.
4.
Gutierrez J, Elkind MS, Cheung K, Rundek T, Sacco RL, Wright CB: Pulsatile and steady components of blood pressure and subclinical cerebrovascular disease: the Northern Manhattan Study. J Hypertens 2016; 33: 2115–2122.
5.
Yang S, Yuan J, Zhang X, Fan H, Li Y, Yin J, Hu W: Higher ambulatory systolic blood pressure independently associated with enlarged perivascular spaces in basal ganglia. Neurol Res 2017; 39: 787–794.
6.
Del Brutto OH, Peñaherrera E, Ochoa E, Santamaría M, Zambrano M, Del Brutto VJ: Door-to-door survey of cardiovascular health, stroke, and ischemic heart disease in rural coastal Ecuador – the Atahualpa Project: methodology and operational definitions. Int J Stroke 2014; 9: 367–371.
7.
Del Brutto OH, Mera RM, Del Brutto VJ, Zambrano M, Lama J: White matter hyperintensities of presumed vascular origin: a population-based study in rural Ecuador (the Atahualpa Project). Int J Stroke 2015; 10: 372–375.
8.
Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, et al: Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol 2013; 12: 822–838.
9.
Pergola PE, White CL, Graves JW, Coffey CS, Tonarelli SB, Hart RG, et al: Reliability and validity of blood pressure measurement in the Secondary Prevention of Small Subcortical Strokes study. Blood Press Monitor 2007; 12: 1–8.
10.
Del Brutto OH, Santamaría M, Ochoa E, Peñaherrera E, Santibáñez R, Pow-Chon-Long F, et al: Population-based study of cardiovascular health in Atahualpa, a rural village of coastal Ecuador. Int J Cardiol 2013; 168: 1618–1620.
11.
Del Brutto OH, Mera RM; Atahualpa Project Investigators: The role of brachial pulse pressure as an indicator of intracranial atherosclerosis: the Atahualpa Project. High Blood Press Cardiovasc Prev 2017; 24: 419–424.
12.
Yang S, Qin W, Yang L, Fan H, Li Y, Yin J, et al: The relationship between ambulatory blood pressure variability and enlarged perivascular spaces: a cross-sectional study. BMJ Open 2017; 7:e015719.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.