scholarly journals Multiscale Dynamics of Blood Pressure Fluctuation Is Associated With White Matter Lesion Burden in Older Adults With and Without Hypertension: Observations From a Pilot Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xin Jiang ◽  
Yi Guo ◽  
Yue Zhao ◽  
Xia Gao ◽  
Dan Peng ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
White Matter ◽  
Pilot Study ◽  
White Matter Lesions ◽  
Structural Mri ◽  
Multiscale Entropy ◽  
Multiple Time Scales ◽  
Multiple Time ◽  
Fazekas Scale

Background: White matter lesions (WMLs) are highly prevalent in older adults, and hypertension is one of the main contributors to WMLs. The blood pressure (BP) is regulated by complex underlying mechanisms over multiple time scales, thus the continuous beat-to-beat BP fluctuation is complex. The association between WMLs and hypertension may be manifested as diminished complexity of BP fluctuations. The aim of this pilot study is to explore the relationships between hypertension, BP complexity, and WMLs in older adults.Method: Fifty-three older adults with clinically diagnosed hypertension and 47 age-matched older adults without hypertension completed one MRI scan and one BP recording of 10–15 min when sitting quietly. Their cerebral WMLs were assessed by two neurologists using the Fazekas scale based on brain structural MRI of each of their own. Greater score reflected higher WML grade. The complexity of continuous systolic (SBP) and diastolic (DBP) BP series was quantified using multiscale entropy (MSE). Lower MSE reflected lower complexity.Results: Compared to the non-hypertensive group, hypertensives had significantly greater Fazekas scores (F > 5.3, p < 0.02) and lower SBP and DBP complexity (F > 8.6, p < 0.004). Both within each group (β < −0.42, p < 0.01) and across groups (β < −0.47, p < 0.003), those with lower BP complexity had higher Fazekas score. Moreover, complexity of both SBP and DBP mediated the influence of hypertension on WMLs (indirect effects > 0.25, 95% confidence intervals = 0.06 – 0.50).Conclusion: These results suggest that diminished BP complexity is associated with WMLs and may mediate the influence of hypertension on WMLs. Future longitudinal studies are needed to examine the causal relationship between BP complexity and WMLs.

scholarly journals The Decreased Complexity of Blood Pressure Dynamics Is Associated With Higher White Matter Lesions in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 213-213
Author(s):  
Xin Jiang ◽  
Xia Gao ◽  
Hui Zhang ◽  
Wuhong Deng ◽  
Wen Fu ◽  
...  
Keyword(s):  
Older Adults ◽  
White Matter ◽  
White Matter Lesions ◽  
Microvascular Disease ◽  
Underlying Mechanism ◽  
Multiscale Entropy ◽  
Multiple Time Scales ◽  
Multiple Time ◽  
Lower Complexity ◽  
Fazekas Scale

Abstract White matter lesions (WML) are highly prevalent in older adults and thought to represent cerebral microvascular disease, contributing to slow gait and dementia. Hypertension is associated with WML. However, the underlying mechanism of this association is unclear. The complex beat-to-beat BP fluctuations represent the influence of BP regulatory mechanisms over multiple time scales. The association between WML and abnormalities in BP regulation may be manifest as a loss of complexity in BP dynamics. The aim of this study is thus to explore the relationships between hypertension, BP complexity, and WML in older adults. Twenty-two older adults with hypertension (SBP>140 mmHg) and 19 age-matched older adults without hypertension (i.e., control) completed this study. Their whole-brain WML were assessed by two neurologists using the Fazekas Scale. Greater score reflects higher WML grade. Each participant completed a 10-minute BP assessment when sitting quietly following the MRI. The continuous SBP and DBP series were recorded, and the complexity of them was quantified using multiscale entropy (MSE). Lower MSE reflects lower complexity. Compared to the controls, hypertensives had significantly greater Fazekas scores (i.e., higher WML grade) (F=4.8, p=0.02) and lower complexity of SBP and DBP (F>3.7, p<0.01), after adjusting for age. Across two cohorts, those with lower SBP and DBP complexity had higher Fazekas score (r<-0.51, p<0.01), and this association was independent of age and group. These results suggest that WML are associated with a loss of complexity in BP dynamics. Future longitudinal studies are needed to examine the causal relationship between WML and BP.

scholarly journals Diastolic Blood Pressure Levels and Ischemic Stroke Incidence in Older Adults With White Matter Lesions

2010 ◽  
Vol 66A (1) ◽  
pp. 74-81 ◽  
Author(s):  
Shoshana Reshef ◽  
Linda Fried ◽  
Norman Beauchamp ◽  
Daniel Scharfstein ◽  
Daniel Reshef ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Ischemic Stroke ◽  
White Matter ◽  
Diastolic Blood Pressure ◽  
White Matter Lesions ◽  
Stroke Incidence

scholarly journals Painting by Lesions: Functional Networks Affected by White Matter Lesions Are Associated with Poorer Cognition

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 490-491
Author(s):  
Rachel Crockett ◽  
Chun Liang Hsu ◽  
Roger Tam ◽  
Todd Handy ◽  
Teresa Liu-Ambrose
Keyword(s):  
Older Adults ◽  
White Matter ◽  
Clinical Sample ◽  
White Matter Lesions ◽  
Functional Networks ◽  
Digit Symbol Substitution Test ◽  
Symbol Substitution ◽  
Trail Making ◽  
Global Cognition ◽  
Visual Network

Abstract Cerebrovascular disease (CvD) is the second most common cause of dementia. Its associated pathology, such as white matter lesions (WML), is associated with reduced cognition. Due to the high variability, the relevance of WML location remains unknown. We hypothesised that although the location of WMLs may appear sporadic, they may actually lie within common functional networks. We used novel imaging methods to map the location of WMLs in a clinical sample with the functional connectivity associated with the same location in the human connectome. This identified the functional networks containing the largest WML load (>50%) in older adults with CvD. We then analyzed the association between level of disruption to these networks and measures of global cognition and executive functions. Included in this study were 164 older adults (>55 years old) with CvD. Cognition was assessed using the: 1) Montreal Cognitive Assessment (MoCA); 2) Stroop Colour Word Test; 3) Trail Making Tests; and 4) Digit Symbol Substitution Test. Our results found that the visual network and ventral attention network (VAN) surpassed the 50% overlap threshold with 85% and 66% overlap respectively. Additionally, after controlling for multiple comparisons and age, the level of disruption to the VAN was significantly associated with poorer global cognition, as measured by the MoCA (p=.001). These novel findings identify the functional networks most affected by the presence of WMLs in older adults with CvD and suggest that the disruption to the VAN caused by WML load may underlie the deficits seen in cognition in this population.

scholarly journals Association of Ambulatory Blood Pressure and Heart Rate With Advanced White Matter Lesions in Ischemic Stroke Patients

2013 ◽  
Vol 27 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Hyuk Sung Kwon ◽  
Young-Hyo Lim ◽  
Hyun Young Kim ◽  
Hee-Tae Kim ◽  
Hyung-Min Kwon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Ischemic Stroke ◽  
White Matter ◽  
Ambulatory Blood Pressure ◽  
White Matter Lesions ◽  
Stroke Patients

scholarly journals Blood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions

2017 ◽  
Vol 9 ◽  
Author(s):  
Kyle C. Kern ◽  
Clinton B. Wright ◽  
Kaitlin L. Bergfield ◽  
Megan C. Fitzhugh ◽  
Kewei Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Blood Pressure Control ◽  
Cerebral Atrophy ◽  
White Matter Lesions ◽  
Pressure Control ◽  
Small Vessel

Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe

Neurology ◽  
2005 ◽  
Vol 64 (2) ◽  
pp. 263-267 ◽  
Author(s):  
T. den Heijer ◽  
L. J. Launer ◽  
N. D. Prins ◽  
E. J. van Dijk ◽  
S. E. Vermeer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
White Matter Lesions

Abstract TP164: Blood Pressure and Heart Rate Measures and Risk of Covert Brain Infarction and Worsening White Matter in Older Adults

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lester Y Leung ◽  
Traci M Bartz ◽  
Kenneth Rice ◽  
James Floyd ◽  
Bruce Psaty ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Heart Rate ◽  
White Matter ◽  
Cardiovascular Health ◽  
Brain Infarction ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Mri Findings ◽  
Increased Risk

Introduction: Covert brain infarction (CBI) and worsening white matter grade (WMG) on serial MRI are associated with increased risk for ischemic stroke and dementia. Hypothesis: We sought to evaluate the association of various measures of blood pressure and heart rate with these MRI findings. Methods: In the Cardiovascular Health Study, a longitudinal cohort study of cardiovascular disease in older adults, we used relative risk regression to assess the risk of incident CBI and worsening WMG associated with mean, variability, and trend in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) measured at four or more annual clinic visits between two brain MRIs. We included participants who underwent both brain MRIs and had no change in antihypertensive medication status, no CBI on the initial MRI, and no stroke before the follow-up MRI. Results: Among 897 eligible participants, incident CBI occurred in 15% and worsening WMG in 27%. Mean SBP mean was strongly associated with increased risk for incident CBI (RR per 10 mmHg 1.29; 95% CI, 1.13-1.47), and DBP mean was strongly associated with increased risk for worsening WMG (RR per 10 mmHg 1.43; 95% CI, 1.23-1.67). DBP variability may be associated with incident CBI (RR per 10 mmHg 1.71; 95% CI, 1.10-2.65), The HR measures were not associated with these MRI findings. Conclusions: Elevated mean levels of blood pressure contribute to covert cerebrovascular diseases. Control of mean blood pressure levels, even in older adults, remains a high priority for prevention of vascular brain injury.

Abstract P191: Association Between Blood Pressure And Brain Volumes Vary By Sex And Age.

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Khawlah Alateeq ◽  
Erin Walsh ◽  
Walter Abhayaratna ◽  
Nicolas Cherbuin
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
White Matter ◽  
Body Mass ◽  
Antihypertensive Medication ◽  
Full Range ◽  
Age Groups ◽  
White Matter Lesions ◽  
Hippocampal Volume ◽  
Brain Volumes

Objective: To quantify the association between blood pressure (BP) across its full range and brain volumes and white matter lesions (WMLs) while investigating the effects of age, sex, body mass index (BMI), antihypertensive medication, and other risk factors. Methods: UK Biobank participants ( N =36,260) aged 40 to 70 years were included and stratified by sex and age into four groups (age ≤ 45, 46-55, 56-65 and > 65 years old). Multi-level regression analyses were used to assess the association between mean arterial (MAP), systolic (SBP), and diastolic (DBP) blood pressure, and brain volumes segmented using the FreeSufer software (gray matter [GMV], white matter [WMV], left [L] and right hippocampal volume [RHCV]) and WMLs. We also investigated the interaction effects between body mass index (BMI) and antihypertensive medication and BP in predicting brain volumes and WMLs. Results: Every 10-mmHg higher DBP was associated with lower brain volumes (GMV: -1300– -2800) [SE=34–90]; WMV: -903.44– -1171.7[SE=34.66–53.03]; LHCV: -7.7– -14.26 [SE=0.44–0.57]; RHCV: -6.25– -22.64[SE=0.32–0.95]) across all age groups. A similar pattern was detected in both sexes, although it was weaker, in men. Also, every 10-mmHg higher MAP was associated with larger WMLs across all age groups but peaked > 65 years (0.1 [SE=0.002]). Both lower BMI and anti-hypertensive medication appeared to afford a protective effect. Conclusion: Higher BP is associated with worse cerebral health across the full BP range from middle adulthood and across the life course. Therefore, it is important that prevention efforts be directed at younger adults with focus on achieving optimal BP to decrease future risk of developing dementia.

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