Abstract:Objective To investigate the relationship between white matter lesions (WML) and ambulatory blood pressure in elderly essential hypertension. Methods Clinical and laboratory data of 130 patients (aged over 80 years) with essential hypertension who hospitalized in Department of Geriatric Neurology, Chinese PLA General Hospital during October 2007 to October 2011 were collected and retrospectively analyzed. They all received cerebral MR imaging and 24-hour ambulatory blood pressure monitoring. They were divided into 3 subgroups according to their white matter changes: mild WML, moderate WML and severe WML groups. Results There were significant differences in systolic and diastolic BP during night, and the percentage of nocturnal BP decline among the 3 groups of patients. Moreover, the prevalence of non-dipper was significantly higher in moderate and severe WML groups than mild WML group. Multiple logistic regression analysis showed that both diastolic BP at night and the percentage of nocturnal BP decline were independent risk factors of WML. Conclusion Elevated night-time BP and abnormal circadian blood pressure rhythm may play important roles in the development of WML in advanced aged patients with essential hypertension.