What question did this study set out to answer?

This research investigates how nighttime blood pressure relates to the burden of intracranial atherosclerotic stenosis and ischemic events.

February 2, 2026

Abstract TP127: Independent Dose-Response Relationships of Nighttime Blood Pressure with Intracranial Atherosclerotic Burden and Ischemic Events

Q: What does this research mean for the field?

Nighttime systolic and mean arterial pressure show independent dose-response associations with intracranial atherosclerotic burden and ischemic events. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Nighttime systolic and mean arterial pressure showed independent dose-response associations with intracranial atherosclerotic burden in multivariate analyses.

Key Points

This research investigates how nighttime blood pressure relates to the burden of intracranial atherosclerotic stenosis and ischemic events.
Performed a multicenter cross-sectional study with 378 patients confirmed to have ICAS.
Conducted 24-hour ambulatory blood pressure monitoring and advanced imaging techniques.
Categorized ICAS burden based on vessel stenosis or occlusion and defined symptomatic ICAS by the occurrence of ischemic events.
Applied logistic regression models to assess BP relationships with ICAS burden and ischemic events.
Used restricted cubic splines to explore non-linear dose-response relationships.
Out of 378 patients, 301 were included in the final analysis.
All ambulatory BP parameters showed positive associations with ICAS burden, even after adjusting for cardiovascular risk factors.
Nighttime systolic BP and mean arterial pressure remained significant for ICAS burden after mutual adjustments.
Identified non-linear relationships for MAP and SBP parameters using cubic spline analyses.
Nighttime diastolic BP and MAP showed independent associations with symptomatic ICAS, primarily exhibiting linear relationships.

Structured PICO

Are nighttime blood pressure parameters associated with intracranial atherosclerotic burden and ischemic events in patients with ICAS?

Population

301 patients with radiologically confirmed intracranial atherosclerotic stenosis (ICAS).

Intervention

Nighttime blood pressure parameters (SBP, DBP, MAP) measured via 24-hour ambulatory blood pressure monitoring.

Outcome

Intracranial atherosclerotic stenosis (ICAS) burden (categorized as low, moderate, or high based on vessels with ≥50% stenosis or occlusion) and symptomatic ICAS (presence of ischemic events attributable to ICAS lesions).surrogate

Nighttime blood pressure exhibits independent dose-response associations with intracranial atherosclerotic burden and ischemic events, highlighting its potential as a target for risk stratification.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: Hypertension is a primary risk factor for intracranial atherosclerotic stenosis (ICAS), yet the role of circadian blood pressure (BP) patterns, particularly nighttime BP, in ICAS burden and related ischemic events remains unclear. We aimed to investigate the associations of ambulatory BP with ICAS burden and ischemic events. Methods: In this multicenter cross-sectional study, 378 patients with radiologically confirmed ICAS underwent 24-hour ambulatory BP monitoring, magnetic resonance angiography, and high-resolution vessel wall imaging. ICAS burden was categorized as low, moderate, or high based on the number of vessels with ≥50% stenosis or occlusion. Symptomatic ICAS (sICAS) was defined by the presence of ischemic events attributable to ICAS lesions. Logistic regression models were used to evaluate associations between BP parameters and ICAS burden or sICAS. Restricted cubic spline (RCS) analyses assessed potential non-linear dose-response relationships. Results: A total of 301 patients were included in the final analysis. All ambulatory BP parameters were positively associated with ICAS burden after adjusting for cardiovascular risk factors. After mutual adjustment between daytime and nighttime BP, only nighttime SBP and mean arterial pressure (MAP) remained independently associated with ICAS burden. RCS analyses showed significant overall associations for all BP parameters, with non-linear relationships identified for 24-hour MAP and daytime SBP, DBP, and MAP. For sICAS, nighttime DBP and MAP remained independently associated, and all associations were predominantly linear. Conclusions: Nighttime BP exhibits independent dose-response associations with ICAS burden and ischemic events, indicating its potential as a target for risk stratification and management.