White Matter Hyperintensities and Apolipoprotein E Affect the Association Between Mean Arterial Pressure and Objective and Subjective Cognitive Functioning in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Youjin Jung ◽  
Raymond P. Viviano ◽  
Sanneke van Rooden ◽  
Jeroen van der Grond ◽  
Serge A.R.B. Rombouts ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Mean Arterial Pressure ◽  
White Matter ◽  
Arterial Pressure ◽  
Cognitive Functioning ◽  
White Matter Hyperintensities ◽  
Whole Brain ◽  
The Relationship

Background: White matter hyperintensities (WMH) show a robust relationship with arterial pressure as well as objective and subjective cognitive functioning. In addition, APOE ɛ4 carriership may influence how arterial pressure affects cognitive functioning. Objective: To determine the role of region-specific WMH burden and APOE ɛ4 carriership on the relationship between mean arterial pressure (MAP) and cognitive function as well as subjective cognitive decline (SCD). Methods: The sample consisted of 87 cognitively unimpaired middle-aged to older adults aged 50–85. We measured WMH volume for the whole brain, anterior thalamic radiation (ATR), forceps minor, and superior longitudinal fasciculus (SLF). We examined whether WMH burden mediated the relationship between MAP and cognition (i.e., TMT-A score for processing speed; Stroop performance for executive function) as well as SCD (i.e., Frequency of Forgetting (FoF)), and whether APOE ɛ4 carriership moderated that mediation. Results: WMH burden within SLF mediated the effect of MAP on Stroop performance. Both whole brain and ATR WMH burden mediated the effect of MAP on FoF score. In the MAP–WMH–Stroop relationship, the mediation effect of SLF WMH and the effect of MAP on SLF WMH were significant only in APOE ɛ4 carriers. In the MAP–WMH–FoF relationship, the effect of MAP on whole brain WMH burden was significant only in ɛ4 carriers. Conclusion: WMH burden and APOE genotype explain the link between blood pressure and cognitive function and may enable a more accurate assessment of the effect of high blood pressure on cognitive decline and risk for dementia.

scholarly journals High Mean Arterial Pressure is Associated with Better Cognitive Function in Older Adults with Subjective Memory Complaints

2021 ◽  
Author(s):  
Ada Wai Tung Fung ◽  
Allen Ting Chun Lee ◽  
Sukling Ma
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cognitive Performance ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Memory Complaints ◽  
Global Cognitive Function

Abstract Background: Hypertension has been shown to be a major risk factor for cognitive decline, but little is known about its association with subjective memory complaints (SMC) in late life. The study is to examine if hypertension is associated with SMC and to explore which blood pressure (BP) is more important in this group.Methods: 497 non-demented older adults aged 60 years or older were interviewed. Hypertension is defined as a BP higher than 130/80 mmHg or on antihypertensive medication. SMC are measured by a validated 5-item Abbreviate Memory Inventory for the Chinese (AMIC) assessing subjective memory deficits in the past month. Cognitive performance was measured by a neurocognitive battery assessing global cognitive function and executive function (EF). Linear regression was performed to examine how different BP associate with AMIC and cognitive performance with adjustment for sociodemographic and physical factors.Results: Hypertensive group had a lower AMIC than normal control (t=-2.1, p=.033). Systolic blood pressure (SBP) (B=-.008, 95% CI -.014 – -.002, p=.006) and mean arterial pressure (MAP) (B=-.011, 95% CI -.020– -.002 p=.014) were associated with AMIC. SBP was only associated global cognitive function (B= .008, 95% CI .000 – .015, p=.038), but MAP was associated with global cognitive function (B=.017, 95% CI .006 – .029, p=.003) and EF (B= 0.16, 95% CI .001 – .030, p=.036). Conclusions: High MAP was associated with better cognitive function in older adults with SMC. The findings highlight the need to be cautious when managing BP in older adults yet not to compromise their current cognitive function.

scholarly journals White Matter Hyperintensities and Medication Adherence

2008 ◽  
Vol 10 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Kathleen C. Insel ◽  
Sheryl L. Reminger ◽  
Chao-Pin Hsiao
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Morphological Changes ◽  
Digit Span ◽  
Wisconsin Card Sorting Test ◽  
Cognitive Assessments ◽  
Prefrontal Function

White matter hyperintensities (WMH) are associated with hypertension, age, and cognitive function, but the association between WMH and medication adherence has not been examined. The intent of this investigation was to consider the potential implications of hypertension-related brain morphological changes on medication adherence and thereby improve understanding of the self-management consequences of hypertension. The associations between WMH, blood pressure, age, cognitive function (specifically assessments of prefrontal function), and medication adherence were examined in 16 middle-aged and older adults self-managing at least one prescribed antihypertensive agent. Magnetic resonance imaging using an axial fluid attenuated inversion recovery (FLAIR) sequence was used to assess the presence of WMH. Cognitive assessments included measures of executive function, working memory, attention, and immediate recall. Adherence was monitored for 8 weeks using electronic medication monitoring. More WMH were associated with poorer adherence (rs = —.25) and with higher systolic blood pressure (rs = .46), although these relationships were not statistically significant. WMH were associated with cognitive assessments in the expected direction including Digit Span Backward (rs = —.53, p < .05). Adherence was associated with immediate memory (rs = .54, p < .05) and inversely associated with failure to maintain set on the Wisconsin Card Sorting Test (WCST; r s = —.61, p < .05). These findings provide preliminary evidence for the association between WMH, assessments of prefrontal function, and medication adherence.

Relationship between the renin–aldosterone system and atrial natriuretic polypeptide in rats

1987 ◽  
Vol 72 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Yasunobu Hirata ◽  
Masao Ishii ◽  
Tokuichiro Sugimoto ◽  
Matsuoka Hiroaki ◽  
Toshihiko Ishimitsu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Blood Pressure Reduction ◽  
Plasma Concentrations ◽  
Inhibitory Effect ◽  
Atrial Natriuretic Polypeptide ◽  
Body Fluid Volume ◽  
The Relationship ◽  
Atrial Natriuretic

1. In order to examine the relationship between the renin–aldosterone system and atrial natriuretic polypeptide (ANP), we investigated the effects of α-human atrial natriuretic polypeptide (α-hANP) on the plasma concentrations of renin (PRC) and aldosterone (PAC), as well as the effects of captopril pretreatment on the natriuresis and blood pressure reduction induced by α-hANP in rats. 2. Although α-hANP infused into conscious rats at 0.67 μg min−1 kg−1 markedly increased the urinary excretion of sodium and decreased mean arterial pressure, its infusion did not change PRC; however, it significantly lowered PAC. Frusemide infusion at 20.8 μg min−1 kg−1 induced natriuresis comparable with that of α-hANP and it elevated both PRC and PAC, but mean arterial pressure was not altered. 3. Pretreatment of rats with captopril did not have any significant influence on the acute natriuretic and hypotensive effects of α-hANP. 4. Although the inhibitory effect of ANP on the renin-aldosterone system may be involved in the chronic modulation of body fluid volume and blood pressure, this effect does not seem to be directly involved in the acute natriuretic and hypotensive effects of the peptide.

Relation of a Socioeconomic Index with Cognitive Function and Neuroimaging in Hypertensive Individuals

2021 ◽  
pp. 1-12
Author(s):  
Regina Silva Paradela ◽  
Naomi Vidal Ferreira ◽  
Mariana Penteado Nucci ◽  
Brenno Cabella ◽  
Luiza Menoni Martino ◽  
...  
Keyword(s):  
Cognitive Function ◽  
White Matter ◽  
Cognitive Performance ◽  
White Matter Hyperintensities ◽  
Social Inequalities ◽  
Parietal Lobe ◽  
Brain Volume ◽  
Linear Regression Models ◽  
Socioeconomic Index ◽  
The Relationship

Background: Socioeconomic factors are important contributors to brain health. However, data from developing countries (where social inequalities are the most prominent) are still scarce, particularly about hypertensive individuals. Objective: To evaluate the relationship between socioeconomic index, cognitive function, and cortical brain volume, as well as determine whether white matter hyperintensities are mediators of the association of the socioeconomic index with cognitive function in hypertensive individuals. Methods: We assessed 92 hypertensive participants (mean age = 58±8.6 years, 65.2%female). Cognitive evaluation and neuroimaging were performed and clinical and sociodemographic data were collected using questionnaires. A socioeconomic index was created using education, income, occupation (manual or non-manual work), and race. The associations of the socioeconomic index with cognitive performance and brain volume were investigated using linear regression models adjusted for age, sex, time of hypertension since diagnosis, and comorbidities. A causal mediation analysis was also conducted. Results: Better socioeconomic status was associated with better visuospatial ability, executive function, and global cognition. We found associations between a better socioeconomic index and a higher parietal lobe volume. White matter hyperintensities were also not mediators in the relationship between the socioeconomic index and cognitive performance. Conclusion: Socioeconomic disadvantages are associated with worse cognitive performance and brain volume in individuals with hypertension.

Abstract P170: Visit-to-visit Blood Pressure Variability Is Associated With Functional Decline In Older Adults: The S.ages Cohort

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Laure Rouch ◽  
Jean-Sébastien Vidal ◽  
Olivier Hanon
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Standard Deviation ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Pressure ◽  
Daily Living ◽  
Blood Pressure Variability ◽  
Functional Decline ◽  
Over Time

Objective: To investigate the impact of visit-to-visit systolic, diastolic, mean arterial pressure and pulse pressure variability on functional decline in non-institutionalized patients aged ≥ 65 years. Methods: 3042 subjects from the S.AGES (elderly subjects) cohort underwent clinical examinations every 6 months during 3 years. Systolic, diastolic, mean arterial pressure and pulse pressure variability were evaluated using standard deviation, coefficient of variation, average real variability, successive variation, variation independent of mean and residual standard deviation. Functional decline was assessed using the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales and defined over time as any help required to perform at least one task. Cox proportional hazards models were used for the analyses. Results: Among the 3042 subjects, 527 (17.3%) had functional decline (ADL) over time. After adjustment for demographics, systolic blood pressure, antihypertensive drugs, coronary artery disease, diabetes mellitus, chronic heart failure, atrial fibrillation, transient ischemic attack or stroke, smoking, dyslipidemia and Mini Mental State Examination at baseline, higher systolic blood pressure variability was associated with greater risk of functional decline (ADL) (adjusted HR per 1-SD increase of coefficient of variation = 1.12, 95% CI [1.03-1.22], p<0.01). Similar results were observed for diastolic blood pressure variability (adjusted HR = 1.11, 95% CI [1.01-1.22], p=0.03) and mean arterial pressure variability (adjusted HR = 1.15, 95% CI 1.05-1.25, p<0.01). Higher pulse pressure variability was no longer significantly associated with functional decline after adjustment for age (p=0.6). Similar patterns were found with all indicators of variability and loss of autonomy defined using IADL. Conclusion: Higher blood pressure variability could be a novel risk factor for functional decline and controlling blood pressure instability a promising interventional target in preserving autonomy in older adults.

scholarly journals Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029179
Author(s):  
Xia Zhang ◽  
Yuqian Li ◽  
Yanhua Wang ◽  
Kai Hu ◽  
Runqi Tu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Rural Population ◽  
Serum Lipids ◽  
Increased Risk ◽  
The Relationship

ObjectivesThe aim of this study was to evaluate the relationship between mean arterial pressure (MAP) and coronary heart disease (CHD) in Chinese rural population. In addition, we hypothesised that this relationship might be mediated by some degree of serum lipids.DesignThis is a cross-sectional study.SettingThe participants were from the Henan Rural Cohort Study, initiated in five rural areas (Tongxu county of Kaifeng city, Yima county of Sanmenxia city, Suiping county of Zhumadian city, Xinxiang county of Xinxiang city and Yuzhou county of Xuchang city) in Henan Province, China, during July 2015 and September 2017.ParticipantsThe study included 39 020 subjects aged 18–79 years as current research population.Outcome measuresSystolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using an electronic sphygmomanometer. MAP was calculated by one-third SBP plus two-thirds DBP. The study used restricted cubic splines and logistic regression models to evaluate the ORs and 95% CIs. Mediation analysis using bootstrap was performed to examine the contribution of serum lipids to MAP-related CHD.ResultsThe adjusted OR (95% CI) for the highest MAP quartile with the risk of CHD was 1.45 (1.24 to 1.69) compared with the lowest quartile. Simultaneously, each 1-SD increment in MAP was significantly associated with a 12% increased risk of CHD. A linear dose–response relationship between MAP and CHD was found (p value for non-linear=0.1169) in the fully adjusted model. We further reported that 36.07% of proportion explained risk of CHD was mediated through serum lipids.ConclusionsIncreased MAP was a significant marker of CHD in Chinese rural population. Meanwhile, the relationship was mediated by some degree of serum lipids, and triglyceride was the strongest mediator.Trial registration numberHenan Rural Cohort study has been registered at Chinese Clinical Trial Register (ChiCTR-OOC-15006699) and the stage it relates to is Post-results.

The relationship between microvasculature in white matter hyperintensities and cognitive function

2016 ◽  
Vol 11 (2) ◽  
pp. 503-511 ◽  
Author(s):  
Jianzhong Sun ◽  
Xinfeng Yu ◽  
Yerfan Jiaerken ◽  
Ruirui Song ◽  
Peiyu Huang ◽  
...  
Keyword(s):  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
The Relationship

[P3-355]: WHITE MATTER HYPERINTENSITIES MODIFY THE RELATIONSHIP BETWEEN HIPPOCAMPAL VOLUME AND VERBAL MEMORY IN OLDER ADULTS WITHOUT DEMENTIA

2017 ◽  
Vol 13 (7S_Part_22) ◽  
pp. P1091-P1092
Author(s):  
Molly E. Zimmerman ◽  
Mindy J. Katz ◽  
Ali Ezzati ◽  
Michael L. Lipton ◽  
Adam M. Brickman ◽  
...  
Keyword(s):  
Older Adults ◽  
White Matter ◽  
Verbal Memory ◽  
White Matter Hyperintensities ◽  
Hippocampal Volume ◽  
The Relationship

scholarly journals Two novel microRNAs and their association with absolute blood pressure parameters in an urban South African community

2021 ◽  
Vol 48 (3) ◽  
pp. 2553-2560
Author(s):  
Don M. Matshazi ◽  
Cecil J. Weale ◽  
Rajiv T. Erasmus ◽  
Andre P. Kengne ◽  
Saarah F. G. Davids ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Diastolic Blood Pressure ◽  
The Novel ◽  
Hypertension Status ◽  
Logistic Regression Models ◽  
Urban South ◽  
African Community ◽  
The Relationship

AbstractMicroRNAs are important in development of disease, and description of novel microRNAs adds to the pool of microRNAs that can be targeted for diagnostic and therapeutic purposes in disease. Herein, we aimed to describe novel microRNAs in a normotensive and hypertensive African population and relate their expression to blood pressure parameters and hypertension status. Previous work using next-generation sequencing showed differential expression of two novel microRNAs in the blood of normotensives and hypertensives. Herein, we have investigated these novel microRNAs by quantitative reverse transcription polymerase chain reaction in a cohort of 881 participants in this study. The relationship between the novel microRNAs and systolic and diastolic blood pressure as well as mean arterial pressure was also investigated. Age and sex-adjusted Spearman’s correlations were used to assess the relationship between microRNAs and cardiovascular risk profile variables whilst multivariable logistic regression models were used to assess the association of microRNAs with screen-detected and known hypertension. The novel microRNAs (miR-novel-chr1_36178 and miR-novel-chr15_18383) were significantly dysregulated by hypertension status. The expression of miR-novel-chr1_36178 differed according to sex, correlated with mean arterial pressure and systolic and diastolic blood pressure at higher levels of expression and was associated with screen-detected hypertension. The association of miR-novel-chr1_36178 expression with mean arterial pressure and systolic and diastolic blood pressure, as well as its dysregulation according to hypertension status suggests its possible utility as a biomarker target for hypertension diagnosis and/or therapeutics. Furthermore, its association with screen detected hypertension and dose-response relationship with blood pressure suggests it may be used to identify and monitor individuals at risk of hypertension.

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