| 수면 중 발생한 뇌졸중 환자에서의 야간 혈압 강하 현상에 관한 연구
: 24시간 혈압 감시 장치를 이용한 전향적 연구 |
| 신원철, 성강주, 장대일, 정경천 |
| 경희대학교 의과대학 신경과학교실 |
| Nocturnal dip in patients with cerebrovascular disease occurring during sleep
: prospective assessment by using Ambulatory Blood Pressure Monitoring |
| Department of Neurology, Collegd of Medicine, Kyung Hee University
Won Chul Shin, M.D., Kang Ju Sung, M.D., Dae-Il Chang, M.D., Kyung-Cheon Chung, M.D. |
| Department of Neurology, College of Medicine, Kyung Hee University
Dondaemoon-gu Hoegi-dong #1, Seoul, 130-702, Korea |
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| Abstract |
Background: There is little knowledge regarding the possible pathogenetic mechanism of cerebrovascular disease
occurring during sleep. We conducted a prospective study using ambulatory blood pressure monitoring to elucidate the
specific characteristics and mechanism in cerebrovascular disease occurrence during sleep. Methods : Stroke were cat-egorized
into the small artery disease and large artery disease, cardiogenic disease, and intracerebral hemorrhage. 24- hour ambulatory blood pressure was carried out within 7 days after stroke onset in 20 patients (11 small artery disease,
7 large artery disease, 1 hemorrhage, 1 Moyamoya disease), and in 21 control patients (10 small artery disease, 9 large
artery disease, 2 hemorrhage), that were admitted with stroke occuring during awakening time. The mean day-time and
night-time systolic and diastolic blood pressure, mean day-time and night-time pulse rate, percentage of nocturnal
blood pressure ([mean daytime BP - mean nighttime BP / average BP for the entire 24 hour] ×100) were calculated.
Results: There was no significant difference between patients with cerebrovascular disease occurring during sleep and
controls in mean day-time and night-time systolic and diastolic blood pressure, mean day-time and night-time pulse
rate. Absence of normal nocturnal blood pressure dip in all stroke subtypes was noted. But, the magnitude of reduced
nocturnal blood pressure decline in small artery disease group was significant smaller than in large artery disease and
control groups (p<.005).
Conclusions: Relatively preserved nocturnal blood pressure dip in small artery disease group
with cerebrovascular disease occurring during sleep is thought that the cerebral ischemia in this subgroup is produced
by excessive falls in the nighttime blood pressure or lowering of night-time blood pressure by antihypertensive agents.
J Kor Neurol Ass 17(3):333 ~ 339, 1999
Key Words : Nocturnal dip, Stroke, Sleep, 24-hour blood pressure monitoring |
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