Cumulative Blood Pressure Exposure, Basal Ganglia, and Thalamic Morphology in Midlife

Abstract

High blood pressure (BP) negatively affects brain structure and function. Hypertension is associated with white matter hyperintensities, cognitive and mobility impairment in late-life. However, the impact of BP exposure from young adulthood on brain structure and function in mid-life is unclear. Identifying early brain structural changes associated with BP exposure, before clinical onset of cognitive dysfunction and mobility impairment, is essential for understanding mechanisms and developing interventions. We examined the effect of cumulative BP exposure from young adulthood on brain structure in a substudy of 144 (61 female) individuals from the CARDIA (Coronary Artery Risk Development in Young Adults) study. At year 30 (Y 30 , ninth visit), participants (56±4 years old) completed brain magnetic resonance imaging and gait measures (pace, rhythm, and postural control). Cumulative systolic and diastolic BP (cumulative systolic blood pressure, cDBP) over 9 visits were calculated, multiplying mean values between 2 consecutive visits by years between visits. Surface-based analysis of basal ganglia and thalamus was achieved using FreeSurfer-initiated Large Deformation Diffeomorphic Metric Mapping. Morphometric changes were regressed onto cumulative BP to localize regions of shape variation. Y 30 white matter hyperintensity volumes were small and positively correlated with cumulative BP but not gait. Negative morphometric associations with cumulative systolic blood pressure were seen in the caudate, putamen, nucleus accumbens, pallidum, and thalamus. A concave right medial putamen shape mediated the relationship between cumulative systolic blood pressure and stride width. Basal ganglia and thalamic morphometric changes, rather than volumes, may be earlier manifestation of gray matter structural signatures of BP exposure that impact midlife gait.

Vascular health across young adulthood and midlife cerebral autoregulation, gait, and cognition

“…Consistent with this premise, we have recently shown that WMH moderate the link between young‐to‐midlife cumulative exposure to higher blood pressure and gait in midlife, but not cognition 7 . Moreover, we have also shown that morphometric changes in basal ganglia and thalamus, rather than volume changes, may represent earlier manifestation of blood pressure exposure on the brain that impact gait in midlife 47 . Future studies, therefore, should further explore the effect of overall vascular health on WMH or brain morphometric changes in the context of gait and cognition.…”

Associations Between Brain Volumes and Cognitive Tests with Hypertensive Burden in UK Biobank

“…We found the subcortical caudate region showed larger volumes in hypertensive participants whereas Cox et al showed a non-significant association. One explanation could be that as this region is adjacent to the ventricles, an area highly susceptible to WHM; it could be possible that WMH could be misclassified as caudate grey matter [ 32 ].…”

“…One explanation could be that as this region is adjacent to the ventricles, an area highly susceptible to WHM; it could be possible that WMH could be misclassified as caudate grey matter [32].…”

Long-Term Physical Activity Participation and Subsequent Incident Type 2 Diabetes Mellitus: A Population-Based Cohort Study

“…We used SAS Proc Traj to fit GBTM models, with details described in Supplemental Methods ( 23 ). For cumulative participation, we used area under the curve (AUC) to calculate cumulative weighted physical activity Z score, based on Trapezoid rule ( 24 ). Details for AUC calculation were presented in Figure 1 .…”