Hypertension Trends and White Matter Brain Injury in the Offspring Framingham Heart Study Cohort-Reference-Cited by-同舟云学术

Hypertension Trends and White Matter Brain Injury in the Offspring Framingham Heart Study Cohort

Published:2024-01 Issue:1 Volume:81 Page:87-95
ISSN:0194-911X
Container-title:Hypertension
language:en
Short-container-title:Hypertension

Author:

Petrea Rodica E.¹²^ORCID,Pinheiro Adlin²³^ORCID,Demissie Serkalem²³,Ekenze Oluchi⁴²^ORCID,Aparicio Hugo J.²⁵,Satizabal Claudia L.²⁵⁶^ORCID,Maillard Pauline⁷^ORCID,DeCarli Charles⁷^ORCID,Beiser Alexa S.²³⁵^ORCID,Seshadri Sudha²⁵⁶^ORCID,Lioutas Vasileios-Arsenios²⁸^ORCID,Rafael Romero Jose²⁵^ORCID

Affiliation:

1. Department of Medicine, Section of Preventive Medicine and Epidemiology (R.P.), Boston University School of Medicine, Boston, MA.

2. NHLBI’s Framingham Heart Study, Framingham, MA (R.P., A.P., S.D., O.E., H.J.A., C.L.S., A.S.B., S.S., V.-A.L., J.R.R.).

3. Department of Biostatistics, Boston University School of Public Health, Boston, MA (A.P., S.D., A.S.B.).

4. Graduate Medical Sciences (O.E.), Boston University School of Medicine, Boston, MA.

5. Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (H.J.A., C.L.S., A.S.B., S.S., J.R.R.).

6. Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX (C.L.S., S.S.).

7. Alzheimer’s Disease Center and Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology and Center for Neuroscience, University of California at Davis School of Medicine, Sacramento, CA (P.M., C.D.).

8. Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (V.-A.L.).

Abstract

BACKGROUND: Hypertension is the most potent stroke risk factor and is also related to cerebral small vessel disease. We studied the relation between mid-to-late-life hypertension trends and cerebral white matter injury in community-dwelling individuals from the FHS (Framingham Heart Study). METHODS: FHS Offspring cohort participants with available mid-life and late-life blood pressure measurements and brain magnetic resonance imaging were included. Multiple regression analyses were used to relate hypertension trends (normotension-normotension [reference], normotension-hypertension, and hypertension-hypertension) to white matter injury metrics on diffusion tensor imaging (free water, fractional anisotropy, and peak skeletonized mean diffusivity) and Fluid Attenuated Inversion Recovery (white matter hyperintensity volume) by different blood pressure cutoffs (130/80, 140/90, and 150/90 mm Hg). RESULTS: We included 1018 participants (mean age 47.3±7.4 years at mid-life and 73.2±7.3 at late-life). At the 140/90 mm Hg cutoff, the hypertension-hypertension trend was associated with higher free water (β, 0.16 [95% CI, 0.03–0.30]; P =0.021) and peak skeletonized mean diffusivity (β, 0.15 [95% CI, 0.01–0.29]; P =0.033). At a 130/80 mm Hg cutoff, the hypertension-hypertension trend had significantly higher free water (β, 0.16 [95% CI, 0.01–0.30]; P =0.035); and the normotension-hypertension (β, 0.24 [95% CI, 0.03–0.44]; P =0.027) and hypertension-hypertension (β, 0.22 [95% CI, 0.04–0.41]; P =0.022) trends had significantly increased white matter hyperintensity volume. Exploratory stratified analysis showed effect modifications by APOE ɛ4 allele and age. CONCLUSIONS: Mid-to-late-life hypertension exposure is significantly associated with microstructural and to a lesser extent, visible white matter injury; the effects are observed at both conventional and lower blood pressure cutoffs and are associated with longer duration of hypertension.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Internal Medicine

Reference33 articles.

1. Association of White Matter Hyperintensity Volume With Decreased Cognitive Functioning

2. Asymptomatic Cerebral Small Vessel Disease: Insights from Population-Based Studies

3. Association of MRI Markers of Vascular Brain Injury With Incident Stroke, Mild Cognitive Impairment, Dementia, and Mortality

4. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges

5. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging