Enlarged Perivascular Spaces in Relation to Cumulative Blood Pressure Exposure and Cognitive Impairment

Shi, Huijing; Hui, Ying; Wang, Anxin; Li, Xiaoshuai; Shu, Rong; Song, Hongxin; Wang, Jierui; Yu, Peiwu; Chen, Shuohua; Li, Jing; Yang, Ling; Wang, Zhenchang; Yang, Qing; Gao, Yuxia

doi:10.1161/hypertensionaha.123.21453

Cited by 9 publications

(4 citation statements)

References 31 publications

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“…All images, including WMH, Lacunes, CMBs, and PVS, were independently evaluated by two experienced neuroradiologists. The consistency of vision has been proved in our previous study 14 .…”

Section: Mr Imaging and Definition Of Csvdsupporting

confidence: 54%

“…For the specific markers of cSVD, we found that the risk effect of long-term variability on SBP was mainly on the PVS (high vs low: OR= 1.62, 95%CI: 1.10-2.39, p = 0.015), and DBP variability only had a risk effect on LA (high vs. low: OR=1.74, 95%CI: 1.06-2.84, p = 0.082. Studies have shown that the high level of office SBP, 24-hour ambulatory SBP 25 , and cumulative SBP were the risk factors for PVS 26 . Our study showed that the long-term variability of SBP was also an independent risk factor for PVS.…”

Section: Discussionmentioning

confidence: 99%

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Higher long-term visit-to-visit blood pressure variability is associated with severe cerebral small vessel disease in the general population

Zhao,

Ying,

et al. 2024

Preprint

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BackgroundLong-term blood pressure (BP) variability is related to several diseases, but its impact on cerebral small vessel disease (cSVD) is uncertain. The study explored the relationship between BP variability, total cSVD burden, and its typical features.MethodThe study involved 1284 participants from the Kailuan cohort. From 2006 to 2022, systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) variability were calculated as low, middle, or high. Magnetic resonance imaging was used to identify white matter hyperintensities (WMH), lacunae (LA), cerebral microbleeds (CMBs), and visible perivascular spaces (PVS). The burden of cSVD was defined as non, mild, moderate, or severe. Logistic regression was used to estimate the odds ratio (OR) and confidence interval (CI).ResultsHigh SBP variability was associated with moderate cSVD burden (OR=1.89, 95% CI: 1.09-3.29) and PVS (OR= 1.62, 95%CI: 1.10-2.39). The DBP was associated with LA (OR=1.74, 95%CI: 1.06-2.84). The PP showed obvious risk effects on moderate/severe cSVD burden (OR= 1.99, 95%CI: 1.17-3.41; OR=2.49, 1.34-4.63). These associations were modified by age and hypertension status. In the young adults (age<60 years old), only high PP variability associated with severe cSVD burden (OR=3.33, 95%CI: 1.31-8.44), LA (OR=3.02, 95%CI: 1.31-6.93), and PVS (OR=1.86, 95%CI: 1.20-2.88). The risk effect of SBP and PP variability on cSVD burden was only significant in the participants with hypertension.ConclusionHigh long-term BP variability, especially in combination with hypertension, is a risk factor for total cSVD burden, LA, and PVS. it is crucial to pay attention to PP variability in young adults.

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“…All images, including WMH, Lacunes, CMBs, and PVS, were independently evaluated by two experienced neuroradiologists. The consistency of vision has been proved in our previous study 14 .…”

Section: Mr Imaging and Definition Of Csvdsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Higher long-term visit-to-visit blood pressure variability is associated with severe cerebral small vessel disease in the general population

Zhao,

Ying,

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

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“…Subjects with vascular risk factors (such as hypertension) tend to have EPVS in the BG and more severe WMH ( 34 ). One large prospective cohort study found high cumulative blood pressure exposure was an independent risk factor for EPVS ( 35 ). High vascular tone could affect cerebral circulation and indirectly impair cerebrospinal fluid flow, further contributing to the development of BG-EPVS ( 15 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

Higher critical closing pressure is independently associated with enlarged basal ganglia perivascular spaces

Zhong,

Lin,

Chen

et al. 2023

Front. Neurol.

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ObjectiveThis study aimed to explore the association between cerebral hemodynamic parameters focused on the critical closing pressure (CCP) and enlarged perivascular spaces (EPVS).MethodsCerebral blood velocity in the middle cerebral artery (MCAv) and non-invasive continuous blood pressure (NIBP) were measured using a transcranial Doppler (TCD) and Finometer, followed by the calculation of cerebral hemodynamic parameters including CCP, resistance area product (RAP), pulsatility index (PI), and pulse pressure (PP). EPVS were graded separately in the basal ganglia (BG) and centrum semiovale (CSO), using a visual semiquantitative ordinal scale. Patients with EPVS >10 were classified into the severe BG-EPVS group and severe CSO-EPVS group, and the remainder into the mild BG-EPVS group and the mild CSO-EPVS group. Spearman’s correlation and binary logistic regression analysis were performed to analyze the relationship between hemodynamic parameters and BG-EPVS and CSO-EPVS, respectively.ResultsOverall, 107 patients were enrolled. The severe BG-EPVS group had higher CCP, mean arterial blood pressure (MABP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) than that in the mild BG-EPVS group (p < 0.05). There was no statistical difference in hemodynamic parameters between the severe CSO-EPVS group and the mild CSO-EPVS group. Spearman’s correlation analysis showed that CCP was positively associated with BG-EPVS (rho = 0.331, p < 0.001) and CSO-EPVS (rho = 0.154, p = 0.044). The binary logistic regression analysis showed that CCP was independently associated with severe BG-EPVS (p < 0.05) and not with CSO-EPVS (p > 0.05) after adjusting for confounders.ConclusionCCP representing cerebrovascular tension was independently associated with BG-EPVS.

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“…The total MoCA score ranges from 0 to 30, with a lower score reflecting poorer cognitive function. A score of less than 26 indicated cognitive impairment [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Hippocampal volume mediates the association of arterial stiffness with cognitive impairment in adult population

Li,

Xing,

Hui

et al. 2024

Journal of Hypertension

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Objectives: To investigate the association of arterial stiffness with brain perfusion, brain tissue volume and cognitive impairment in the general adult population. Materials and methods: This prospective study included 1488 adult participants (age range: 22.8–83.9 years) from the Kailuan study. All participants underwent brachial–ankle pulse wave velocity (PWV) measurement, brain MRI, and Montreal Cognitive Assessment (MoCA). The association of PWV with cerebral blood flow (CBF), brain tissue volume and MoCA score was investigated. Mediation analysis was used to determine whether CBF and brain tissue volume changes mediated the associations between PWV and MoCA score. Results: A 1 standard deviation (SD) increase in PWV was associated with lower total brain CBF [β (95% CI) −0.67 (−1.2 to −0.14)], total gray matter CBF [β (95% CI) −0.7 [−1.27 to −0.13)], frontal lobe CBF [β (95% CI) −0.59 (−1.17 to −0.01)], parietal lobe CBF [β (95% CI) −0.8 (−1.43 to −0.18)], and temporal lobe CBF [β (95% CI) −0.68 (−1.24 to −0.12)]. Negative associations were found for PWV and total brain volume [β (95% CI) −4.8 (−7.61 to −1.99)] and hippocampus volume [β (95% CI) −0.08 (−0.13 to −0.04)]. A 1 SD increase PWV was significantly associated with elevated odds of developing cognitive impairment [odds ratio (95% CI) 1.21 (1.01–1.45)]. Mediation analysis showed that hippocampal volume partially mediated the negative association between PWV and MoCA scores (proportion: 14.173%). Conclusion: High arterial stiffness was associated with decreased total and regional CBF, brain tissue volume, and cognitive impairment. Hippocampal volume partially mediated the effects of arterial stiffness on cognitive impairment.

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Enlarged Perivascular Spaces in Relation to Cumulative Blood Pressure Exposure and Cognitive Impairment

Cited by 9 publications

References 31 publications

Higher long-term visit-to-visit blood pressure variability is associated with severe cerebral small vessel disease in the general population

Higher long-term visit-to-visit blood pressure variability is associated with severe cerebral small vessel disease in the general population

Higher critical closing pressure is independently associated with enlarged basal ganglia perivascular spaces

Hippocampal volume mediates the association of arterial stiffness with cognitive impairment in adult population

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