Longitudinal systolic blood pressure characteristics and integrity of white matter tracts in a cohort of very old black and white adults.
Bottom Line: Higher mean SBP was associated with lower white matter integrity in uncinate and superior lateral fasciculi bilaterally, independent of age, stroke history, antihypertensive medication use (odds ratio of having white matter hyperintensities greater than or equal to the median for 10mm Hg of SBP = 10.4, 95% confidence interval = 10.2-10.6, P = 0.0001; standardized beta for fractional anisotropy = -13.54, SE = 4.58, P = 0.003).Associations with gray matter measures were not significant.Whether lowering and/or stabilizing SBP levels in very old adults without a remarkable cardiovascular history would have neuroprotective effects and reduce dementia risk needs further study.
Affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; firstname.lastname@example.org.Show MeSH
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Mentions: Among the SBP characteristics examined, overall higher mean and group trajectories of SBP were associated with higher WMH prevalence (P = 0.002 and P = 0.048, respectively) and with lower FA of total brain (P = 0.001 and P = 0.02, respectively). Pulse pressure at study entry was also associated with higher WMH prevalence and with lower FA (P = 0.03 for both). By contrast, SBP at study entry, SBP or pulse pressure at time of neuroimaging, coefficient of variation, SBP load, and SBP peak measured from study entry to time of neuroimaging were not associated with WMH or FA (Supplementary Table 1). The association of antihypertensive medication intake with higher prevalence of WMH was not significant, but the association with lower FA was significant (P = 0.03).The relationships of WMH and FA with antihypertensive medication intake, mean SBP, and load SBP measured from study entry to time of neuroimaging are illustrated in Figure 2. Associations between each type of antihypertensive medication at time of neuroimaging and WMH were also not significant (Supplementary Table 2).
Affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; email@example.com.