Association Between the Circadian Rhythm of Arterial Blood Pressure and White Matter Lesions in Hospitalized Hypertensive Patients: A Cross-Sectional Study.

Background: White matter lesions (WMLs) are associated with an increased risk of stroke, cognitive impairment, and vascular dementia. Hypertension stands as the most significant modifiable independent risk factor contributing to WMLs. However, little is known about the relationship between WMLs and altered circadian rhythms of blood pressure (BP) in patients with essential hypertension. Methods: This cross-sectional observational study enrolled patients diagnosed with essential hypertension. Participants were stratified into mild, moderate, and severe WMLs subgroups based on Fazekas scale assessments, with a control group of individuals without WMLs. All participants underwent 24-hour ambulatory BP monitoring and were classified according to circadian rhythm patterns: dipper, non-dipper, and antidipper. Comparative analyses were performed on demographic characteristics, ambulatory BP profiles, and circadian rhythm patterns across groups. Univariate analysis and multivariate logistic regression were employed to identify independent risk factors for WMLs. Results: 33 in the control group and 112 in the WMLs group were included. There were significant differences in age, history of diabetes mellitus and cardiovascular disease ( Conclusion: Age and non-dipper and antidipper patterns are associated with an increased risk of WMLs. Non-dipper BP is an independent risk factor for WMLs. Middle-aged and elderly people with primary hypertension with non-dipper BP need to manage and control nocturnal BP.