Association between blood pressure levels over time and brain atrophy in the elderly

The relation between blood pressure level and degree of global brain atrophy is equivocal. We evaluated past and present blood pressure levels and change in blood pressure over 20 years in relation to the degree of cortical atrophy on magnetic resonance imaging (MRI). In 1995-1996, we measured blood pressure and performed MRI in 1077 nondemented elderly (age 60-90 years). For 513 of these, we had information on a blood pressure level 20 years before. The degree of cortical atrophy was semi-quantitatively scored (range 0-15). In late life, a high (>/=90 mmHg) and low (<65 mmHg) diastolic blood pressure were associated with more cortical atrophy than a diastolic blood pressure level between 65-74 mmHg (adjusted difference 0.60 units (95% confidence interval (CI), 0.18-1.02) and 0.77 units (0.28-1.25), respectively). Persons whose diastolic blood pressure had declined more than 10 mmHg over 20 years had more cortical atrophy than those with stable blood pressure levels (adjusted difference 0.53 units, 0.05-1.02). Both high and declining diastolic blood pressure levels are associated with more global brain atrophy on MRI.

[1]  O Sabri,et al.  Neuropsychological impairment correlates with hypoperfusion and hypometabolism but not with severity of white matter lesions on MRI in patients with cerebral microangiopathy. , 1999, Stroke.

[2]  J. Haxby,et al.  Brain atrophy in hypertension. A volumetric magnetic resonance imaging study. , 1992, Hypertension.

[3]  G. Alexander,et al.  Interactive effects of age and hypertension on volumes of brain structures. , 1997, Stroke.

[4]  A. Hofman,et al.  Determinants of disease and disability in the elderly: The Rotterdam elderly study , 1991, European Journal of Epidemiology.

[5]  Matthijs Oudkerk,et al.  Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study. , 2000 .

[6]  C. DeCarli,et al.  Biobehavioral characteristics of nondemented older adults with subclinical brain atrophy , 2000, Neurology.

[7]  B. Lernfelt,et al.  A population-based study on blood pressure and brain atrophy in 85-year-olds. , 1998, Hypertension.

[8]  W. Markesbery,et al.  Midlife blood pressure and neuritic plaques, neurofibrillary tangles, and brain weight at death: the HAAS☆ , 2000, Neurobiology of Aging.

[9]  D. Sparks,et al.  Increased incidence of neurofibrillary tangles (NFT) in non-demented individuals with hypertension , 1995, Journal of the Neurological Sciences.

[10]  C. DeCarli,et al.  Predictors of brain morphology for the men of the NHLBI twin study. , 1999, Stroke.

[11]  K. Meguro,et al.  Periventricular hyperintensity on magnetic resonance imaging correlated with brain ageing and atrophy , 2004, Neuroradiology.

[12]  C. Mathers,et al.  Coffee and cholesterol. , 1983, Lancet.

[13]  B. Lernfelt,et al.  15-year longitudinal study of blood pressure and dementia , 1996, The Lancet.

[14]  C. Grady,et al.  Reduction of Functional Neuronal Connectivity in Long‐term Treated Hypertension , 1994, Stroke.

[15]  J. C. Torre,et al.  Critically attained threshold of cerebral hypoperfusion: the CATCH hypothesis of Alzheimer’s pathogenesis , 2000, Neurobiology of Aging.

[16]  M. Breteler.  Vascular Involvement in Cognitive Decline and Dementia: Epidemiologic Evidence from the Rotterdam Study and the Rotterdam Scan Study , 2000, Annals of the New York Academy of Sciences.

[17]  A Hofman,et al.  A follow‐up study of blood pressure and cerebral white matter lesions , 1999, Annals of neurology.

[18]  A. Hofman,et al.  Blood Pressure and Risk of Dementia: Results from the Rotterdam Study and the Gothenburg H-70 Study , 2000, Dementia and Geriatric Cognitive Disorders.

[19]  J. Hatazawa,et al.  Association of Hypertension with Increased Atrophy of Brain Matter in the Elderly , 1984, Journal of the American Geriatrics Society.

[20]  Nick C Fox,et al.  Imaging of onset and progression of Alzheimer's disease with voxel-compression mapping of serial magnetic resonance images , 2001, The Lancet.

[21]  W. Burke,et al.  Blood pressure regulation in Alzheimer's disease. , 1994, Journal of the autonomic nervous system.

[22]  E P Steinberg,et al.  Magnetic resonance abnormalities and cardiovascular disease in older adults. The Cardiovascular Health Study. , 1994, Stroke.

[23]  J. Swales.  Textbook of hypertension , 1994 .

[24]  Moody Dm,et al.  Does tortuosity in cerebral arterioles impair down-autoregulation in hypertensives and elderly normotensives? A hypothesis and computer model. , 1991 .

[25]  Matthijs Oudkerk,et al.  Incidence and Risk Factors of Silent Brain Infarcts in the Population-Based Rotterdam Scan Study , 2003, Stroke.

[26]  F. Fazekas,et al.  Magnetic resonance imaging cerebral abnormalities and neuropsychologic test performance in elderly hypertensive subjects. A case-control study. , 1995, Archives of neurology.