Grant: CIHR Fellowship

Cerebral small vessel disease encompasses ischemic strokes, hemorrhages, silent strokes, vascular cognitive impairment and dementia. It is the lead cause of vascular cognitive impairment and dementia, affecting approximately 250000 Canadians. Hypertension is a powerful risk factor for stroke, small vessel disease and cognitive impairment and affects nearly 7 million Canadians. Though there is a clear relationship between blood pressure and risk of small vessel disease, there is also emerging evidence that variability of blood pressure (unprovoked, irregular fluctuations) may also play an important role in risk of stroke and cognitive impairment. Our aims are to define variability of blood pressure and examine its relationship with small vessel events including stroke, brain abnormalities on MRI and cognitive impairment using data from the Secondary Prevention of Small Subcortical Strokes (SPS3) study, which is a randomized controlled trial with 3000 participants with more than 58000 blood pressure measurements. We also wish to examine other factors that may affect blood pressure variability, including age, race, gender and class of blood-pressure lowering medication.