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Increased diastolic blood pressure is associated with MRI biomarkers of dementia-related brain pathology in normative ageing.
- Source :
-
Age and ageing [Age Ageing] 2018 Jan 01; Vol. 47 (1), pp. 95-100. - Publication Year :
- 2018
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Abstract
- Background: hypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer's disease pathology.<br />Objective: to examine relationships between blood pressure (BP) components and brain pathology in older adults.<br />Subjects: two hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years.<br />Methods: BP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships.<br />Results: higher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = -0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = -0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011).<br />Conclusion: increased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer's diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies.<br /> (© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com)
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Alzheimer Disease etiology
Alzheimer Disease pathology
Cerebrovascular Disorders etiology
Cerebrovascular Disorders pathology
Diastole
Female
Hippocampus pathology
Humans
Hypertension diagnosis
Hypertension physiopathology
Leukoencephalopathies etiology
Leukoencephalopathies pathology
Male
Middle Aged
Predictive Value of Tests
Risk Factors
Scotland
White Matter pathology
Aging metabolism
Alzheimer Disease diagnostic imaging
Blood Pressure
Cerebrovascular Disorders diagnostic imaging
Hippocampus diagnostic imaging
Hypertension complications
Leukoencephalopathies diagnostic imaging
Magnetic Resonance Imaging
White Matter diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2834
- Volume :
- 47
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Age and ageing
- Publication Type :
- Academic Journal
- Accession number :
- 29106439
- Full Text :
- https://doi.org/10.1093/ageing/afx102