{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:48:10Z","timestamp":1789678090881,"version":"4.0.1"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,16]]},"abstract":"\n Background<\/jats:title>\n \n Abnormal circadian blood pressure (\n BP<\/jats:styled-content>\n ) variations during sleep, specifically the non\u2010dipping (<10% fall in nocturnal\n BP<\/jats:styled-content>\n ) and reverse\u2010dipping patterns (rise in nocturnal\n BP<\/jats:styled-content>\n ), have been associated with an increased risk of cardiovascular events and target organ damage. However, the relationship between abnormal sleep\n BP<\/jats:styled-content>\n variations and cerebral small vessel disease markers is poorly established. This study aims to assess the association between non\u2010dipping and reverse\u2010dipping\n BP<\/jats:styled-content>\n patterns with markers of silent cerebral small vessel disease.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n MEDLINE<\/jats:styled-content>\n , Embase, and Cochrane Databases were searched from inception through November 2019. Studies that reported the odds ratios (ORs) for cerebral small vessel disease markers in patients with non\u2010dipping or reverse\u2010dipping\n BP<\/jats:styled-content>\n patterns were included. Effect estimates from the individual studies were extracted and combined using the random\u2010effect, generic inverse variance method of DerSimonian and Laird. Twelve observational studies composed of 3497 patients were included in this analysis. The reverse\u2010dipping compared with normal dipping\n BP<\/jats:styled-content>\n pattern was associated with a higher prevalence of white matter hyperintensity with a pooled adjusted OR of 2.00 (95%\n CI<\/jats:styled-content>\n , 1.13\u20132.37; I\n 2<\/jats:sup>\n =36%). Non\u2010dipping\n BP<\/jats:styled-content>\n pattern compared with normal dipping\n BP<\/jats:styled-content>\n pattern was associated with higher prevalence of white matter hyperintensity and asymptomatic lacunar infarction, with pooled\n OR<\/jats:styled-content>\n s of 1.38 (95%\n CI<\/jats:styled-content>\n , 0.95\u20132.02; I\n 2<\/jats:sup>\n =52%) and 2.33 (95%\n CI<\/jats:styled-content>\n , 1.30\u20134.18; I\n 2<\/jats:sup>\n =73%), respectively. Limiting to only studies with confounder\u2010adjusted analysis resulted in a pooled\n OR<\/jats:styled-content>\n of 1.38 (95%\n CI<\/jats:styled-content>\n , 0.95\u20132.02; I\n 2<\/jats:sup>\n =52%) for white matter hyperintensity and 1.44 (95%\n CI<\/jats:styled-content>\n , 0.97\u20132.13; I\n 2<\/jats:sup>\n =0%) for asymptomatic lacunar infarction.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The non\u2010dipping and reverse\u2010dipping\n BP<\/jats:styled-content>\n patterns are associated with neuroimaging cerebral small vessel disease markers.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.016299","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T10:06:12Z","timestamp":1591005972000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Impact of Circadian Blood Pressure Pattern on Silent Cerebral Small Vessel Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7973-8267","authenticated-orcid":false,"given":"Anthipa","family":"Chokesuwattanaskul","sequence":"first","affiliation":[{"name":"Division of Neurology Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"},{"name":"King Chulalongkorn Memorial Hospital Thai Red Cross Society Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wisit","family":"Cheungpasitporn","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Mississippi Medical Center Jackson MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charat","family":"Thongprayoon","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saraschandra","family":"Vallabhajosyula","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Bathini","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mayo Clinic Jacksonville FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam D.","family":"Cato","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust Birmingham United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4463-7447","authenticated-orcid":false,"given":"Ronpichai","family":"Chokesuwattanaskul","sequence":"additional","affiliation":[{"name":"King Chulalongkorn Memorial Hospital Thai Red Cross Society Bangkok Thailand"},{"name":"Department of Medicine Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.02.003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2165\/00129784-200505010-00002"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328363e964"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy475"},{"key":"e_1_3_2_6_2","first-page":"127","article-title":"Causes and consequences of a non\u2010dipping blood pressure profile","volume":"65","author":"Birkenhager AM","year":"2007","unstructured":"Birkenhager AM, van den Meiracker AH. Causes and consequences of a non\u2010dipping blood pressure profile. Neth J Med. 2007;65:127\u2013131.","journal-title":"Neth J Med"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jim-2017-000513"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200109000-00004"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-017-1270-3"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/10641963.2019.1619757"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.115.06981"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12659"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/hy1101.099502"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3109\/07420528.2010.510230"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70104-6"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004328"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30079-1"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021160"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.47.2.500"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1159\/000071213"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1159\/000084498"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.100610"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.558049"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2010.04.002"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2011.118"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2011.06.030"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000290"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-14-8"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ensci.2017.12.002"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.08.002"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey221"},{"key":"e_1_3_2_36_2","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]","author":"Higgins JPT","year":"2011","unstructured":"Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: www.handbook.cochrane.org."},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000930"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000014509.11540.66"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007654"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40292-019-00320-w"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1159\/000446082"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-802395-2.00007-9"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2019.01.009"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-019-0167-4"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.3109\/07420528.2012.715872"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8091367"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000604"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.03.046"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70124-8"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2018.03608"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002267"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.04.043"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2017.05.011"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000355"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.016299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:31:54Z","timestamp":1715599914000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.016299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,16]]},"references-count":53,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,6,16]]}},"alternative-id":["10.1161\/JAHA.119.016299"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.016299","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,16]]},"assertion":[{"value":"2020-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e016299"}}