Gender difference in association between H-type hypertension and subcortical ischemic vascular disease

Abstract

BackgroundSubcortical ischemic vascular disease (SIVD) is a leading cause of vascular dementia. The present study tries to explore not only the gender-specific association between H-type hypertension and SIVD but also the indirect effects of H-type hypertension on cognition through the ischemic brain injury caused by SIVD.Materials and methodsA total of 601 SIVD patients were included, comprising 322 males and 279 females. H-type hypertension was defined as hypertension accompanied with elevated serum total homocysteine (tHcy) level. The imaging manifestations of ischemic brain injury caused by SIVD were also evaluated, including white matter lesions (WML), lacunar infarction (LI) and brain atrophy (BA). Gender-specific subgroup analyses in association between H-type hypertension and SIVD were conducted, followed by a structural equation model based evaluation of the gender-specific mediating effects of SIVD on the relationship between H-type hypertension and cognition.ResultsFor males, there was no noticeable difference in WML, LI and BA scores among control group, isolated hypertension group, isolated high tHcy group, and H-type hypertension group in most brain regions, but significant difference was found in all brain regions for females. Multiple regression analyses showed that H-type hypertension was significantly associated with WML, LI and BA for females, but not for males. For males, H-type hypertension mainly affected cognition through direct effect, while the H-type hypertension effect was mediated by ischemic brain injury caused by SIVD for females.ConclusionH-type hypertension was more closely related to SIVD for females than males, suggesting a gender-specific difference in association patterns between H-type hypertension and cognition.

Association analysis of the gut microbiota in predicting outcomes for patients with acute ischemic stroke and H-type hypertension

“…Studies have reported that HHTN contributed to more cerebrovascular disease (CVD), such as stroke (8), and ultimately led to higher mortality (9,10). Compared with simple stroke patients, patients with both HHTN and stroke were reported to have a higher death rate and a greater potential for cognitive disorders (11,12).…”

H-type Hypertension Status and Influencing Factors of the Elderly People Over 80 Years Old Based on Random Forest Model

“…Previous studies have shown that intestinal flora and blood uric acid levels are closely associated with Hcy. The elevation of plasma Hcy levels is mainly related to the following factors: 1) Nutritional factors: Hcy is negatively correlated with folic acid and 8) Vitamin B12 9) levels in the body; 2) Genetic factors: gene mutation, inherited methylation cycle abnormalities; 10) 3) Gender and age: Hcy is higher in males than in females and increases with age; 11) 4) Other: smoking, alcohol consumption, 12) lack of exercise, 13) psychiatric factors, etc. However, few of the above studies have been conducted with patients aged over 80 years, and their complex disease composition and physical status necessitate a unique prevalence mechanism analysis of H-type hypertension.…”