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대뇌 백질변성과 고혈압 유형: 안산 연구
Original Article
Dementia and Neurocognitive Disorders 2002: 1: 2: 107-112	전문보기
박문호, 박민규, 박건우, 신철†
강화군 서도면 보건지소, 고려대학교 의과대학 신경과학교실*, 안산헬스연구소†
Cerebral White Matter Lesions and Hypertesion Type: the Ansan Study
Moon Ho Park, M.D., Min Kyu Park, M.D., Kun Woo Park, M.D., Chol Shin, M.D.†, FCCP., Dae Hie Lee, M.D.*
Seodo-myen Health Subcenter, Ganghwa-gun, Incheon; Department of Neurology* & Ansan Health Center†, College of Medicine, Korea University, Seoul, Korea
Background : It is known that white matter lesions (WMLs) may be related to hypertension. The relationship of WMLs to hypertension subtypes, however, remains uncertain. Very few studies have been performed regarding WMLs in Korean people. We investigated the association beween the presence and the severity of WMLs with hypertension, its subtypes, and its control status among Koreans. Methods : A population-based sample of the people aged older than 60 years in Ansan Cohort Study was selected, yielding 108 men and 115 women. Their blood pressure was measured using a highly standardized protocol. Hypertension was defined according to 1999 WHO-ISH guidelines and its subtypes were subclassified. Hypertensives were selected and they were subclassified as hypertensives, isolated systolic hypertensives, and isolated diastolic hypertensives. The subjects were further divided into antihypertensive medication and no medication groups. WMLs were rated into 5 subgroups in terms of the presence and the severity by 2 raters using 1.5T MRI scan images. The correlation between WMLs and hypertension subtypes were made. Results : WMLs were related to hypertension. For hypertension subtypes, systolic blood pressure was more related to WMLs. Among no medication groups with hypertension, isolated systolic hypertensives (odds ratio [OR]=2.66; 95% CI=1.08-6.57; p<0.05) and hypertensives (OR=2.55; CI=1.19-5.46; p<0.05) were related to more extensive WMLs by multiple regression analysis. Among antihypertensive medication groups, uncontrolled hypertension (OR=6.07; CI=2.08-17.78; p<0.01) was significantly related to WMLs compared to normotensives. Conclusions : Hypertension is a strong independent risk factor of WMLs among Koreans. Regular and tight control of hypertension appears to be of great importance in preventing WMLs in hypertensives.
Key Words: White matter hyperintensities, Hypertension, Korean

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