Association of Blood Pressure, White Matter Lesions, and Regional Cerebral Blood Flow

Zhang, Dong; Zhang, Jianyu; Zhang, Bo; Zhang, Jin; He, Minqiang

doi:10.12659/msm.929958

Cited by 11 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 147 patients from a Chinese neurology department exhibiting WMH, higher Fazekas scores were associated with higher BP, lower cognitive performance assessed by MoCA, and lower cerebral blood flow. Associations were significant both for PVH and DWMH with slightly stronger associations for PVH than DWMH like in our analysis [35]. Also, in a cohort of 618 patients with ischemic stroke or transient ischemic attack, hypertension identified in medical records was significantly associated with higher PVH and DWMH in univariable but only with PVH in multivariable analyses adjusted for age and diabetes [7].…”

Section: Discussionsupporting

confidence: 73%

Periventricular rather than deep white matter hyperintensities mediate effects of hypertension on cognitive performance in the population-based 1000BRAINS study

Gronewold

Jokisch

Schramm

et al. 2022

Journal of Hypertension

View full text Add to dashboard Cite

Objectives: White matter hyperintensities (WMH) of presumed vascular origin are frequent in cerebral MRI of older people. They represent a sign of small vessel disease, are promoted by arterial hypertension, and relate to cognitive deficits. The interdependence of blood pressure and its treatment, WMH, and cognitive performance has not systematically been studied in population-based studies.Methods: Consequently, we analysed the interdependence of SBP, DBP, and antihypertensive medications, as well as BP/treatment category, with WMH and cognitive performance in 560 participants of the population-based 1000BRAINS study.Results: BP, its treatment, and BP/treatment category were moderately associated with cognitive performance (e. g. unadjusted b ¼ À0.10, 95%CI ¼ À0.19 to À0.02 for the association of SBP (per standard deviation of 17.2 mmHg) with global cognition (per standard deviation of 0.5 z score)]. The harmful effect of BP on cognition was strongly mediated by periventricular hyperintensities (PVH), which were significantly associated with both SBP [b ¼ 0.24, 95% CI ¼ 0.14-0.34 (per 1-point-increase in Fazekas score)] and global cognition (b ¼ À0.22, 95%CI ¼ À0.32 to À0.13). Thus, PVH mediated as much as 52% of the effects of SBP on cognitive performance. Mediation was less strong for deep white matter hyperintensities (DWMH, 16%), which showed less association with SBP (b ¼ 0.14, 95% CI ¼ 0.05-0.24) and global cognition (b ¼ À0.12, 95% CI ¼ À0.21 to À0.03). Regarding different cognitive domains, PVH most strongly mediated effects of SBP on nonverbal memory (94%) and executive function (81%). Conclusion:Our results indicate that PVH may predispose to cognitive impairment associated with hypertension, especially in the domains of nonverbal memory and executive function.

show abstract

Section: Discussionsupporting

confidence: 73%

Periventricular rather than deep white matter hyperintensities mediate effects of hypertension on cognitive performance in the population-based 1000BRAINS study

Gronewold

Jokisch

Schramm

et al. 2022

Journal of Hypertension

View full text Add to dashboard Cite

show abstract

“…After also adjusting for blood pressure differences, the percentage of regions showing lower age-related cerebral blood reduced to 36%. These results are consistent with previous research [35-40] suggesting that elevated blood pressure in ageing is an important contributor to cerebral hypoperfusion. We discuss the possible mechanisms driving these results below.…”

Section: Discussionsupporting

confidence: 94%

Insulin resistance alters the coupling between cerebral blood flow and glucose metabolism in younger and older adults: Implications for neurovascular coupling

Deery,

Liang,

Di Paolo

et al. 2024

Preprint

View full text Add to dashboard Cite

Rising rates of insulin resistance and an ageing population are set to exact an increasing toll on individuals and society. Here we examine the contribution of insulin resistance and age to the coupling of cerebral blood flow and glucose metabolism; a critical process in the supply of energy for the brain. Thirty-four younger (20-42 years) and 41 older (66-86 years) healthy adults underwent a simultaneous resting state MR/PET scan, including arterial spin labelling. Rates of cerebral blood flow and glucose metabolism were derived using a functional atlas of 100 brain regions. Older adults had lower cerebral blood flow than younger adults in 95 regions, reducing to 36 regions after controlling for cortical atrophy and blood pressure. Younger and older insulin sensitive adults showed small, negative correlations between relatively high rates of regional cerebral blood flow and glucose metabolism. This pattern was inverted in insulin resistant older adults, who showed hypoperfusion and hypometabolism across the cortex, and a positive coupling. In insulin resistant younger adults, coupling showed inversion to positive correlations, although not to the extent seen in older adults. Our findings suggest that the normal course of ageing and insulin resistance alter the rates and coupling of cerebral blood flow and metabolism. They underscore the criticality of insulin sensitivity to brain health across the adult lifespan.

show abstract

“…In our previous study [ 18 ], we found that in terms of WMLs, nocturnal BP increase might be more dangerous than daytime BP increase. A study by Dirk Sander emphasized that circadian SBP changes, especially nocturnal SBP increase, might play a pivotal role in the pathogenesis of WMLs [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Rhythm and Blood Pressure Variability as Risk Factors for White Matter Lesions: A Cross-Sectional Study

Zhang

et al. 2021

Med Sci Monit

Self Cite

View full text Add to dashboard Cite

Background White matter lesions are common in the elderly. The aim of this study was to explore the correlation between blood pressure rhythm and blood pressure variability with white matter lesions. Material/Methods A total of 144 subjects aged 40 to 80 years underwent MRI scanning to assess the degree of white matter lesions using the Fazekas scale. The regional cerebral blood flow was detected by brain perfusion imaging, and an ambulatory blood pressure monitor was used to measure the circadian blood pressure rhythm. Odds ratio and the 95% confidence interval was computed using logistics regression analysis. The relationship between various factors and blood pressure was calculated by curve simulation. Results With the increase of white matter lesions, the regional cerebral blood flow at the lesion decreased gradually. Systolic blood pressure day/night difference ratio (OR=0.815, 95% CI 0.729–0.910), diastolic blood pressure day/night difference ratio (OR=0.895, 95% CI 0.831–0.964), systolic blood pressure coefficient of variation (OR=1.589, 95% CI 1.273–1.983), and diastolic blood pressure coefficient of variation (OR=1.363, 95% CI 1.150–1.616) were significantly associated with Fazekas score ( P <0.05 for all). Conclusions Greater blood pressure variability and blood pressure rhythm disorders were associated with lower regional cerebral blood flow in patients with white matter lesions.

show abstract

Association of Blood Pressure, White Matter Lesions, and Regional Cerebral Blood Flow

Cited by 11 publications

References 0 publications

Periventricular rather than deep white matter hyperintensities mediate effects of hypertension on cognitive performance in the population-based 1000BRAINS study

Periventricular rather than deep white matter hyperintensities mediate effects of hypertension on cognitive performance in the population-based 1000BRAINS study

Insulin resistance alters the coupling between cerebral blood flow and glucose metabolism in younger and older adults: Implications for neurovascular coupling

Blood Pressure Rhythm and Blood Pressure Variability as Risk Factors for White Matter Lesions: A Cross-Sectional Study

Contact Info

Product

Resources

About