Blood Pressure and White-Matter Disease Progression in a Biethnic Cohort. Atherosclerosis Risk in Communities (ARIC) Study
Rebecca F. Gottesman,Josef Coresh,Diane J. Catellier,A. Richey Sharrett,Kathryn M. Rose,Laura H. Coker,Dean Shibata,David S. Knopman,Clifford R. Jack,Thomas H. Mosley +9 more
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TLDR
Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models, and earlier SBP measurements were stronger predictors ofWMH progression than were later SBp measurements, but in blacks only.Abstract:
Background and Purpose— Blood pressure (BP) is a predictor of concurrent and subsequently measured white-matter hyperintensity (WMH), but longitudinal studies of WMH changes and data in black participants are lacking. We hypothesized that WMH progression would be (1) strongly related to BP in blacks and whites and (2) predicted more strongly by earlier (midlife) or cumulative BP measurements than by measures at older ages. Methods— Participants were 983 individuals (49% black) from the Atherosclerosis Risk in Communities (ARIC) Study who underwent cerebral magnetic resonance imaging in 1993–1995 and 2004–2006. Associations between BP (measured at each of 5 visits, in addition to a time-averaged cumulative BP) and progression of WMHs were analyzed and compared. Results— Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models. Higher cumulative SBP (by 20 mm Hg) was associated with greater progression of WMHs and was similar in blacks (2.5 cm3, P<0.0001) and whites ...read more
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Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging
TL;DR: Potential mechanisms, detectable with neuroimaging, that might better fit the available evidence and provide testable hypotheses for future study are discussed.
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White matter hyperintensities, cognitive impairment and dementia: an update.
Niels D. Prins,Philip Scheltens +1 more
TL;DR: A timely Review on WMHs, including their relationship with cognitive decline and dementia, is provided, although evidence for effective interventions is still lacking.
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Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline.
Stéphanie Debette,Sudha Seshadri,Sudha Seshadri,Alexa S. Beiser,Alexa S. Beiser,Rhoda Au,Rhoda Au,Jayandra J. Himali,Jayandra J. Himali,Carole L. Palumbo,Philip A. Wolf,Philip A. Wolf,Charles DeCarli +12 more
TL;DR: Longitudinal changes in brain structure were significantly correlated with decline in memory and executive function and hypertension, diabetes, smoking, and obesity were associated with an increased rate of progression of vascular brain injury, global and hippocampal atrophy, and decline in executive function a decade later.
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Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association
Costantino Iadecola,Kristine Yaffe,José Biller,Lisa C. Bratzke,Frank M. Faraci,Philip B. Gorelick,Martha Gulati,Hooman Kamel,David S. Knopman,Lenore J. Launer,Jane S. Saczynski,Sudha Seshadri,Adina Zeki Al Hazzouri +12 more
TL;DR: Judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.
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Neurovascular and Cognitive Dysfunction in Hypertension
TL;DR: Hypertension has emerged as a leading cause of age-related cognitive impairment as mentioned in this paper and is associated with dementia caused by vascular factors, hypertension has more recently been linked also to Alzheimer disease-the major cause of dementia in older people.
References
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The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators.
TL;DR: In each of four US communities, 4,000 adults aged 45-64 years will be examined twice, three years apart, to investigate the etiology of atherosclerosis and its clinical sequelae and variation in cardiovascular risk factors, medical care, and disease by race, sex, place, and time.
Journal Article
The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators
Journal ArticleDOI
Clinical Correlates of White Matter Findings on Cranial Magnetic Resonance Imaging of 3301 Elderly People: The Cardiovascular Health Study
W. T. Longstreth,Teri A. Manolio,Alice M. Arnold,Gregory L. Burke,Nick Bryan,Charles A. Jungreis,Paul L. Enright,Daniel H. O'Leary,Linda P. Fried +8 more
TL;DR: White matter findings were significantly associated with age, silent stroke, hypertension, FEV1, and income, and may not be considered benign because they are associated with impaired cognitive and lower extremity function.
Journal ArticleDOI
The Association Between Midlife Blood Pressure Levels and Late-Life Cognitive Function: The Honolulu-Asia Aging Study
TL;DR: Midlife SBP is a significant predictor of reduced cognitive function in later life and early control of SBP levels may reduce the risk for cognitive impairment in old age.
Journal ArticleDOI
Adjusting for treatment effects in studies of quantitative traits: antihypertensive therapy and systolic blood pressure.
TL;DR: Two of the adjustment methods based on a censored normal regression model appear to perform well across a range of realistic settings and there is no argument for undertaking a flawed analysis that wastes power and results in excessive bias.
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