Volume of white matter hyperintensities increases with blood pressure in patients with hypertension

Objective Hypertension is a risk factor for development of white matter hyperintensities (WMHs). However, the relationship between hypertension and WMHs remains obscure. We sought to clarify this relationship using clinical data from different regions of China. Methods We analyzed the data of 333 patients with WMHs in this study. All included patients underwent conventional magnetic resonance imaging (MRI) examination. A primary diagnosis of WMHs was made according to MRI findings. The volume burden of WMHs was investigated using the Fazekas scale, which is widely used to rate the degree of WMHs. We conducted retrospective clinical analysis of the data in this study. Results Our findings showed that WMHs in patients with hypertension were associated with diabetes, cardiovascular diseases, history of cerebral infarct, and plasma glucose and triglyceride levels. Fazekas scale scores for WMHs increased with increased blood pressure values in patients with hypertension. Conclusion This analysis indicates that hypertension is an independent contributor to the prevalence and severity of WMHs.

[1]  P. Scheltens,et al.  Age, Hypertension, and Lacunar Stroke Are the Major Determinants of the Severity of Age-Related White Matter Changes , 2006, Cerebrovascular Diseases.

[2]  Jan Cees de Groot,et al.  Interaction Between Hypertension, apoE, and Cerebral White Matter Lesions , 2004, Stroke.

[3]  C. Ayers,et al.  Effect of Normal Aging Versus Hypertension, Abnormal Body Mass Index, and Diabetes Mellitus on White Matter Hyperintensity Volume , 2014, Stroke.

[4]  P. Scheltens,et al.  White matter hyperintensities, cognitive impairment and dementia: an update , 2015, Nature Reviews Neurology.

[5]  N. Raz,et al.  Differential Aging of the Brain: Patterns, Cognitive Correlates and Modifiers , 2022 .

[6]  Christos Davatzikos,et al.  White matter hyperintensities and imaging patterns of brain ageing in the general population. , 2016, Brain : a journal of neurology.

[7]  F. Barkhof,et al.  Alterations in white matter volume and integrity in obesity and type 2 diabetes , 2016, Metabolic Brain Disease.

[8]  C. DeCarli,et al.  Relationship of Family History Scores for Stroke and Hypertension to Quantitative Measures of White-Matter Hyperintensities and Stroke Volume in Elderly Males , 2000, Neuroepidemiology.

[9]  A. Newman,et al.  Hypertension, White Matter Hyperintensities, and Concurrent Impairments in Mobility, Cognition, and Mood: The Cardiovascular Health Study , 2011, Circulation.

[10]  T. Nakai,et al.  Frontal White Matter Hyperintensity Is Associated with Verbal Aggressiveness in Elderly Women with Alzheimer Disease and Amnestic Mild Cognitive Impairment , 2018, Dementia and Geriatric Cognitive Disorders Extra.

[11]  V. Mok,et al.  Hyperhomocysteinemia is associated with volumetric white matter change in patients with small vessel disease , 2006, Journal of Neurology.

[12]  A. Convit,et al.  Cerebral White Matter and Retinal Arterial Health in Hypertension and Type 2 Diabetes Mellitus , 2013, International journal of hypertension.

[13]  D. Collins,et al.  White matter hyperintensities are linked to future cognitive decline in de novo Parkinson's disease patients , 2018, NeuroImage: Clinical.

[14]  M. Kılınç,et al.  High sensitivity C-reactive protein and cerebral white matter hyperintensities on magnetic resonance imaging in migraine patients , 2015, The Journal of Headache and Pain.

[15]  J. Wardlaw,et al.  Perivascular spaces and their associations with risk factors, clinical disorders and neuroimaging features: A systematic review and meta-analysis , 2019, International journal of stroke : official journal of the International Stroke Society.

[16]  Yi-Chung Wu.  C-reactive protein and cerebral white matter lesions , 2012, Clinical Neurology and Neurosurgery.

[17]  Joanna M Wardlaw,et al.  What are White Matter Hyperintensities Made of? , 2015, Journal of the American Heart Association.

[18]  L. Wahlund,et al.  Topography and Determinants of Magnetic Resonance Imaging (MRI)‐Visible Perivascular Spaces in a Large Memory Clinic Cohort , 2017, Journal of the American Heart Association.

[19]  Christine Fennema-Notestine,et al.  Hypertension-Related Alterations in White Matter Microstructure Detectable in Middle Age , 2015, Hypertension.

[20]  G. Alves,et al.  White matter hyperintensities, executive function and global cognitive performance in vascular mild cognitive impairment. , 2013, Arquivos de neuro-psiquiatria.

[21]  Xiang Lin,et al.  Risk factors of cerebral microbleeds in young and middle-aged patients with hypertension , 2018, Neurological research.

[22]  Jayesh Modi,et al.  Association of White Matter Hyperintensities With Short-Term Outcomes in Patients With Minor Cerebrovascular Events , 2018, Stroke.

[23]  Xin Lou,et al.  Reduced perfusion in normal‐appearing white matter in mild to moderate hypertension as revealed by 3D pseudocontinuous arterial spin labeling , 2016, Journal of magnetic resonance imaging : JMRI.

[24]  Wenli Hu,et al.  Relationship Between White Matter Hyperintensities Penumbra and Cavity Formation , 2016, Medical science monitor : international medical journal of experimental and clinical research.

[25]  Heung-Kook Choi,et al.  Grading and Interpretation of White Matter Hyperintensities Using Statistical Maps , 2014, Stroke.

[26]  Z. Cai,et al.  Prevalence of white matter hyperintensities increases with age , 2018, Neural regeneration research.

[27]  R. Kalaria,et al.  White matter degeneration in vascular and other ageing‐related dementias , 2018, Journal of neurochemistry.

[28]  N. Venketasubramanian,et al.  Growth differentiation factor-15 and white matter hyperintensities in cognitive impairment and dementia , 2016, Medicine.

[29]  Natalia S. Rost,et al.  Hyperlipidemia and Reduced White Matter Hyperintensity Volume in Patients With Ischemic Stroke , 2010, Stroke.

[30]  M. Zoli,et al.  Hypertension and Other Determinants of White Matter Lesions in Stroke Patients , 2016, Journal of clinical hypertension.

[31]  P. Sachdev,et al.  Are the brain's vascular and Alzheimer pathologies additive or interactive? , 2017, Current opinion in psychiatry.

[32]  L. McEvoy,et al.  White matter disease in midlife is heritable, related to hypertension, and shares some genetic influence with systolic blood pressure , 2016, NeuroImage: Clinical.

[33]  W. M. van der Flier,et al.  Quantitation of brain tissue changes associated with white matter hyperintensities by diffusion‐weighted and magnetization transfer imaging: The LADIS (leukoaraiosis and disability in the elderly) study , 2009, Journal of magnetic resonance imaging : JMRI.

[34]  S. Oparil,et al.  Intensive blood pressure lowering prevents mild cognitive impairment and possible dementia and slows development of white matter lesions in brain: the SPRINT Memory and Cognition IN Decreased Hypertension (SPRINT MIND) study , 2018, Blood pressure.

[35]  A. Pavlovic,et al.  Increased risk of cognitive impairment and more severe brain lesions in hypertensive compared to non‐hypertensive patients with cerebral small vessel disease , 2018, Journal of clinical hypertension.

[36]  F. Tanaka,et al.  White matter hyperintensities on MRI in dementia with Lewy bodies, Parkinson's disease with dementia, and Alzheimer's disease , 2018, Journal of the Neurological Sciences.

[37]  Frederik Barkhof,et al.  Progression of White Matter Hyperintensities and Incidence of New Lacunes Over a 3-Year Period: The Leukoaraiosis and Disability Study , 2008, Stroke.

[38]  Linn B. Norbom,et al.  Increased MRI-based cortical grey/white-matter contrast in sensory and motor regions in schizophrenia and bipolar disorder , 2016, Psychological Medicine.